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IMPROVING PUBLIC HEALTH OUTREACH FOR WASHINGTON COAST RAZOR
CLAM HARVESTERS

by
Carrie Frazier

A Thesis
Submitted in partial fulfillment
of the requirements for the degree
Master of Environmental Studies
The Evergreen State College
December 2017

©2017 by Carrie Frazier. All rights reserved.

This Thesis for the Master of Environmental Studies Degree
by
Carrie Frazier

has been approved for
The Evergreen State College
by

________________________
Edward A. Whitesell, Ph.D.
Member of the Faculty

________________________
Date

ABSTRACT
Improving Public Health Outreach for Washington Coast Razor Clam Harvesters
Carrie Frazier
On the Washington coast, harvesting and consuming shellfish provides many populations
with recreational, intergenerational, socio-cultural, and economic benefits. Shellfish
consumption however, simultaneously, places physical health at risk. Biotoxins, such as
domoic acid, are naturally occurring, and can be one of many causes of a harvest closure.
Using an interview methodology of razor clam harvesters to explore the Washington
Department of Health’s harvest closure outreach, this thesis investigates where
populations go to receive shellfish closure information, their perceptions of closures,
motivations, and the ways in which the Department of Health can further improve public
health outreach methods to better address their needs. This study concludes that a welldesigned, targeted advisory can successfully transform a message into one that leads to
appropriate knowledge and behavior change. These results aim to improve the disconnect
between the public and state agencies designing public health messages. In addition, this
thesis contributes to the literature around public health outreach, specifically focusing on
how tailored messages can match the motivations, needs, and current level of awareness
into shellfish harvest closures.

Table of Contents
List of Figures......................................................................................................................v
Acknowledgements.............................................................................................................vi
Chapter 1: Introduction....................................................................................................1
Chapter 2: Literature Review: An Analysis of Health Communication......................7
Tailored and Targeted Health Communication....................................................................7
Sociocultural Factors.........................................................................................................12
Learning Theory.................................................................................................................17
Speaking Like a State.........................................................................................................18
Risk Communication.........................................................................................................20
Chapter 3: Methodology..................................................................................................27
Chapter 4: Results: The Voice of Razor Clam Harvesters..........................................37
Chapter 5: Discussion and Conclusion..........................................................................55
References.........................................................................................................................64

iv

List of Figures
Figure 1. The Washington Department of Health Beach Closure Signage ........................1
Figure 2. Identified Razor Clam Harvesting Areas...........................................................30
Figure 3. The Washington Department of Health Shellfish Safety Map...........................47

v

Acknowledgements
This thesis would not have been possible without the help of the following:
My thesis reader, Dr. Edward Whitesell (Ted), for providing his continued patience,
support, and feedback in the process of developing this research and writing.
The Washington Department of Health Biotoxin Monitoring Program, for the opportunity
to work as their intern, and guiding and encouraging this research.
The razor clam harvesters who took the time to participate in interviews, and provide
their insight and knowledge.
All my gratitude for the love and support provided throughout this journey from friends
in the MES cohort. Especially Dakota Burt, and my roommate Mary Silva.
My family back home in West Virginia, for supporting my move across the country, and
never questioning why of all things to focus on, I chose shellfish.
And my grandmother, Virginia Frazier.

vi

Chapter 1: Introduction
The skull and crossbones symbol is a clear indication of a risk, warning, or danger
to human wellbeing and health. In Washington State, one risk to human health is the
consumption of shellfish. Molluscan bivalve shellfish, or shellfish with a two-hinged
shell such as mussels, clams, scallop, geoduck, and oysters, are filter-feeders. In the
process of filter-feeding large amounts of water, small bacteria, naturally occurring
organisms, viruses, and other contaminants present can be absorbed into the tissue of the
shellfish (Rodríguez-Lázaro et al., 2012). If contaminant levels are high enough, the
harvested shellfish can make individuals who consume them ill.

Figure 1. The Washington Department of Health Beach Closure Sign (Courtesy of
the WDOH website)
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Shellfish harvesting, however, holds significance beyond just a tasty meal. For
some communities, a diet of shellfish holds economic, spiritual, socio-cultural, and
recreational benefits. Since the mid-1800s, shellfish have been harvested in the nutrientrich waters of Washington, and today, Washington State is the nation’s leading producer
of farmed clams, oysters, and mussels (Grant, 2015). The 2011 Washington Shellfish
Initiative estimated that state shellfish growers directly and indirectly employ more than
3,200 people and provide an estimated total economic contribution of $270 million
(Grant, 2015).
Recreational shellfish harvesting also brings in large numbers. In recent years,
Washingtonians and visitors made almost half a million trips to Puget Sound and the
coast to recreationally harvest clams and oysters. The razor clam fishery in Washington is
also a significant source of revenue for tourism- dependent businesses such as restaurants
and motels (WDFW, 2017). The different incentives and experienced benefits of shellfish
harvesting further contributes to the ways in which people experience the impacts related
to harvest closures. These individual benefits are further postponed when harvest closures
are put into effect by state agencies to protect public health.
The Washington State Department of Health (WDOH) is one agency responsible
for the monitoring and communication of shellfish closures to the public. Within the
WDOH’s division of Environmental Public Health is the Marine Biotoxin Monitoring
Program. The goal of the Biotoxins and Illness Prevention Program is to protect humans
from illness and death caused by eating Washington-grown shellfish contaminated with
biotoxins, which are produced by certain kinds of phytoplankton that are naturally
present in marine waters (WDOH, 2017). Shellfish in both recreational and commercial
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harvest areas are routinely tested for biotoxins known to be present in Washington's
marine waters, such as Paralytic Shellfish Poison, Diarrhetic Shellfish Poison, and
Amnesic Shellfish Poison (also known as domoic acid) (WDOH, 2017). Due to its
increased abundance, this research will focus solely on domoic acid closures in
Washington coastal shellfish harvesting.
Domoic acid (DA) is one of the many causes of shellfish harvest closures in
Pacific razor clams Siliqua patula. The first detection of DA in razor clams from Oregon
and Washington coastal beaches took place in October and November of 1991 (Wekell et
al., 1994). The first DA- related closure of shellfish harvesting in Puget Sound,
Washington, occurred in early September 2003 owing to a DA concentration of 29 ppm
(parts per million) measured in blue mussels from Fort Flagler, Kilisut Harbor (Cox,
Horner, Borcher, & Trainer, 2006). Although DA had been detected in Puget Sound
waters by the Washington State Department of Health’s (WDOH) routine monitoring
program, prior to 2003, levels had never exceeded the regulatory limit of 20ppm (Cox,
Horner, Borcher, & Trainer, 2006). Commercial, recreational, and subsistence razor clam
fisheries suffered total coastwide closures in the 1991-92, 1997-98 and 2002-03 seasons
(Trainier et al., 2006). Extended closures can not only produce frustrations, but economic
hardships for communities such as local indigenous tribes that rely on subsistence
fisheries.
Presumed causes of recent DA spikes lean on possible environmental conditions
that may exacerbate blooms. Warming ocean temperatures for example can impact cell
growth rates, duration of optimal growth period, and stratification intensity of nearshore
waters due to increased glacial melt, but to date the relationship between ocean warming
3

and its potential effects on the spatial and temporal magnitude, and toxicity of natural
blooms is unknown both here and elsewhere in the world (Trainer et al., 2006).
Continuing research has pointed to certain cause and effect situations, but the exact
combination of conditions that causes algal blooms is not yet known (WDOH, 2017).
After a beach closure is put into effect, the WDOH continues to test the closed
area, and when lab results confirm that biotoxin concentrations have dropped to safe
levels, the beach will reopen to harvest (WDOH, 2017). When an area that is on or near a
public beach is closed, the WDOH notifies the local health department and issues a news
release about the closure (WDOH, 2017). The WDOH also posts the closure information
on its website and bilingual recorded hotline to inform recreational harvesters that
shellfish in that area are not safe to eat. In addition, “danger”, “warning”, or “closure”
signs are placed directly on the entrances to closed beach sites.
Since 1932, the Department of Health has been working to protect public health
with routine lab testing of shellfish at various locations in Washington. When a harvest
site is determined closed for public health safety, notifying clam harvesting groups and
communicating closure information to large and varied populations can be quite complex.
By understanding the current methods being pursued by harvesters, the WDOH can begin
to develop the means necessary to address this complex communication.
While the exact number of shellfish related illnesses occurring in Washington
State is unknown due to populations not seeking medical help or being unaware of acute
symptoms, the increase in DA concentrations is known. A record-setting bloom of DAproducing diatoms occurred along the U.S. West Coast from spring 2015 through early
2016, causing fisheries closures of razor clams, Dungeness crabs, sardines, and
4

negatively impacting marine mammals along the North American West Coast (McCabe
et al., 2016). This bloom was considered a preview of future conditions, as increased
frequency and toxicity of DA-producing phytoplankton blooms are predicted under future
ocean acidification and warming scenarios (Wells, 2015). With the predicted increase of
DA exposure, evaluation of the effectiveness of public health outreach tools will be
needed.
This thesis addresses the following three questions:
1. How effective are the outreach methods employed by the Washington Department
of Health’s biotoxin monitoring program?
2. What are the individual motivations of razor clam harvesters?
3. How much awareness does the shellfish community have in regards to shellfish
illnesses?
The Department of Health currently uses a variety of outreach methods: a bilingual
recorded hotline number for updated biotoxin closures; an interactive online shellfish
safety map; shellfish danger, warning, and closure signs posted in eight different
languages; media publications; and an online biotoxin bulletin updated daily with closure
information.
However, there remains uncertainty as to where populations go to receive harvest
closure information. This thesis aims to investigate where populations access closure
information, and how familiar they are with the current outreach tools used by the
Washington Department of Health. The conclusions will be shared with the Washington
State Department of Health Office of Environmental Health and Safety to aid in future
development of shellfish closure outreach.
5

To gain a better understanding of how closure outreach can be improved to
address the needs of the public, in-person interviews of recreational razor clam harvesters
were conducted from identified harvest sites on the Pacific Coast of Washington. While
previous studies (Burger et al., 2003, Jardine, 2003) have surveyed and explored outreach
of closure information in regards to fish consumption advisories, this thesis will
specifically focus on the recreational effects of DA closures on the Pacific coast within
these areas.
Overall, the purpose of this research is to provide agencies with an improved
understanding of the needs of their audiences, in hopes of designing effective outreach
targeted to meet their needs. This is done by exploring the theoretical basis of health
communication in the literature review portion. The literature broaches the topic of
tailored and non-tailored health education materials and their effectiveness in helping
individuals change health-related behaviors. An overview of the methods used in this
study will be provided.
Lastly, a discussion of the results of this study and recommendations for the
Department of Health’s broader communication methods to protect public health is
provided. The answers to the initial three thesis questions provide the jumping off point
for recommendations to create shellfish closure outreach designed to meet the needs of its
audience. Beyond its recommendations for this research, this thesis contributes to the
literature around public health outreach, specifically focusing on how tailored messages
can match the motivations, needs, and current level of awareness into shellfish harvest
closures.

6

Chapter 2: Literature Review: An Analysis of Health Communication
This chapter presents a review of the existing scholarship from the disciplines of
health communication, risk assessment, and health education. These fields have been
chosen for the significance they provide in addressing the effectiveness and theoretical
outlines of public health messages reaching their audiences. At times, these fields of
study merge to address topics of environmental justice and community education within
health outreach, which will also be explored in this section. This thesis draws upon the
field of health education, which is relatively unexplored to date in research
comprehending the sources of outreach material utilized most by Washington razor clam
harvesters, as well as their own awareness, ways they interpret and learn, and motivations
into the causes of closures.
The purpose of this literature review is to examine the implications these
messages may produce for state agencies developing health outreach targeted at specific
audiences, such as the Washington coastal razor clam populations. To address this gap in
the published literature, this research subsequently focus on the ways in which state
agencies and other entities can use health communication strategies to increase awareness
of closures and create relevant outreach material.
Tailored and Targeted Health Messages
A dominant theme in health communication strategies and approaches is tailored
and targeted messages to audiences. Additionally, studies of the chosen communication
method are becoming central in the discussion of improved outreach to at-risk
populations. One overarching conclusion is that customization of the message is
important for materials to be effective (Kreuter et al., 2000). The literature broaches the
7

topic of targeted and tailored health education materials and their effectiveness in helping
individuals change health-related behaviors. Kreuter et al. (2000) define targeted
communication as intended to reach some population subgroup based on characteristics
presumed to be shared by the group members.
In their study of targeted health communication, Perez-Stable et al. researched
creating a targeted educational booklet designed to promote breast and cervical cancer
screening among Latinas in San Francisco. This booklet was created using cultural
components that target ethnic-specific misconceptions about the causes of cancer (PerezStable et al., 1996). The targeted booklet was based on a composite profile of a specific
population subgroup (Latinas in San Francisco) and was produced in just one version
specially designed for this subgroup. Its focus was primarily on those characteristics
assumed to be shared by many members of the subgroup.

Tailored communication, on the other hand, is intended to reach a specific
individual based on specific, measurable characteristics of that person that have been
tested in a formal assessment. Despite these fundamental differences, the rationale for
both methods is similar: the more one knows about the intended recipients of a
communication, the better one will be able to make the message relevant to them
(Kreuter & Wray, 2003).
The tailoring methodology has been tested using print materials for women’s
cancer screening. In their study (Skinner et al., 1994) created tailored physician
recommendation letters that were sent to women patients in a primary care setting. To
participate, eligible women completed a brief telephone survey assessing their stage of

8

readiness, perceived barriers and perceived benefits for getting a mammogram (Skinner
et al., 1994).

Based on the provided information, and demographic and risk status data,
individualized letters were generated and sent to women at their homes. Each letter
contained a drawing of a woman tailored to the race and age of the recipient. Below each
of these drawings was a testimonial caption that was tailored to the recipient's stage of
readiness to get a mammogram. Text messages in the letters addressed each woman's
specific barriers to getting a mammogram, beliefs about mammography and breast
cancer, stage of readiness to change, and breast cancer risk. Follow-up interviews were
conducted 8 months later and found that tailored letter recipients were more likely to
remember and to have read more of their letters than standardized version recipients
(Skinner, 1994).
Similarly, in their study, “Are tailored health education materials always more
effective than non-tailored materials?” Kreuter and his colleagues studied 198 overweight
adults who were randomly assigned to receive either tailored or non-tailored weight-loss
materials. Participants’ cognitive, affective, and behavioral responses to the materials
were measured through a goodness of fit score that was calculated to reflect how well
these materials addressed each person’s unique weight loss needs at an immediate and
one month follow up. Findings showed that good-fitting, non-tailored materials
performed as well or better than tailored materials for several cognitive, affective, and
behavioral outcomes (Kreuter et al., 200). However, moderate- and poor-fitting, nontailored materials were consistently inferior to both approaches (Kreuter et al., 2000).

9

This method can further assist in tailoring explicit messages to at risk populations such as
pregnant women.
A limitation that should be noted in any study of this nature is that the participants’
cognitive, behavioral, and affective responses to tailored and non-tailored materials may
not be representative of how those with different or without any health problems, would
react to printed education materials.
The customization of tailored messages is proposed to catch individuals’ attention,
meet their information needs, and positively affect their cognitive-behavioral responses to
health information (Stellefson, 2008). In their study, “Effects of a tailored health
promotion program for female blue-collar workers: Health works for women” (Campbell
et al., 2002) assessed the effects of the Health Works for Women (HWW) intervention on
improving multiple behaviors including nutrition and physical activity among rural,
female, blue-collar employees in North Carolina. The hypothesis was that tailoring
messages to focus on a woman’s behavioral priority might result in greater success in
achieving at least one behavior change, which in turn might be a “gateway” leading to
increased motivation and confidence to tackle additional problem behaviors in the future
(Campbell et al., 2002).

This two-pronged intervention included (a) individualized, computer-tailored,
“women’s magazines” that provided personalized feedback, strategies for change, and
community resource information and (b) a natural helpers intervention that trained
women in the workplace to diffuse information and provide support for healthy behavior
changes (Campbell et al., 2002). Tailoring variables included name, workplace, age, shift,
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health concerns (pregnancy, limitations to exercise), and current health behaviors
including fat, fruit and vegetable intake, frequency and duration of different types of
leisure-time physical activity (categorized as aerobic and strengthening/flexibility),
smoking, cancer screening, and choice of behavioral priority for change. Computer-based
tailoring algorithms were written to use the individual survey data and decision rules
determined by the research team to access the appropriate messages and graphics from
the message library. These tailored elements were then assembled in a predetermined
format and layout in the tailored magazine. Using statistical analysis this study found the
strongest effect was for fruit and vegetable consumption, with an increase of 0.7 daily
servings achieved among women in the intervention group at the 18-month follow-up.
The study results suggest that the combination of two tailored magazines plus the natural
helper program over 18 months resulted in the observed behavior changes, whereas
giving one tailored magazine alone had no measurable effect.

Other health studies have compared tailored materials to generic self-help materials.
Sutton and Gilbert (2008) researched tailored smoking cessation health outreach. In their
study, the control group received usual care (telephone counselling and an information
pack sent through the post). The intervention group received in addition a computergenerated individually tailored advice letter. For the sample as a whole, quit rates did not
differ significantly between the two conditions. However, among the majority (n = 1164)
who were smokers at baseline, quit rates were consistently higher in the intervention
group, with prolonged abstinence for 3 months (Sutton & Gilbert, 2008).

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According to Sutton & Gilbert, some studies report little-to-no improvements in
outcomes when tailoring health messages (Stellefson, 2008). Bull et al. (1999) study
results revealed that although more tailored subjects reported some physical activity at
each follow-up compared with the standard group, these differences were not significant.
Furthermore, there was no significant difference in movement across the stages of
readiness to exercise at follow-up between subjects in the tailored group who received
material targeting their current stage (precontemplation or contemplation) and the
standard group who received generic material that addressed both stages (Bull et al.,
1999). This could be due to the differential applications of tailoring methods and how
different people and populations respond to tailored versus non-tailored material.

There are instances where tailoring messages cannot improve lack of awareness
regarding a novel health topic. Thus, if there is an unrelenting use of tailoring regardless
of an individual’s previous exposure to health information, there lies the possibility of
exhausting excess discretionary resources during the formative stages of message
development
Sociocultural Factors
Tailored and targeted health communication can be taken a step further by ensuring
the message or advisory is also constructed to address sociocultural differences.
Sociocultural differences can include religiosity, collectivism, and racial pride (Kreuter et
al., 2004). Using the sociocultural approach, a group’s cultural values, beliefs, and
behaviors are recognized, reinforced, and built upon to provide context and meaning to
information and messages about health (Kreuter & Mcclure, 2004).

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Cultural targeting is consistent with several core principles of practice in public health
(e.g., addressing problems in the populations most affected) and health education (e.g.,
making programs relevant to the populations they serve) (Kreuter et al., 2003). The role
for cultural tailoring in health communication would include understanding how
individuals perceive their own culture, the extent to which they identify with it, and the
specific cultural values that are important to them (Kreuter et al., 2003).

In addition, the cultural characteristics of any particular group may be directly or
indirectly associated with health-related priorities, decisions, behaviors, and/or with
acceptance and adoption of health education and health communication programs and
messages (Kreuter & Mcclure, 2004). For example, a cultural group’s traditional dietary
practices could promote or prevent certain diseases (i.e., a direct effect). Subsistence
shellfish harvesting and consumption is one example.

DeWesee et al. (2009) produced fish consumption advisory maps for Anishnaabe
communities that provided lake-specific, risk-based, culturally sensitive consumption
advice on color-coded maps for two groups: children under age 15 years and females of
childbearing age, and males 15 years and older and females beyond childbearing age.
Because the maps were easy to read and developed in conjunction with community
members, DeWeese et al. (2009) found they significantly increased the percentage of
survey participants who indicated awareness of advisory information and increased
preference for smaller walleye, which contain lower levels of contamination than larger
fish.

13

The research methodology and development of a revised advisory for this study used
focus groups of three local tribes. The focus groups addressed general issues such as the
level of detail included in an advisory map as well as risk assessment and risk
management issues that influenced the structure and composition of maps (DeWeese et
al., 2009)

Kalichman & Coley (1995) used a cultural component in their study Witness
Project. Witness Project was developed to educate and promote breast and cervical
cancer screening among low-income African-American women in rural Arkansas.
Kalichman and Coley randomly assigned 100 African-American women in an urban
health clinic in Milwaukee to view one of three videos on HIV testing. The first had an
African-American man as the narrator; the second was identical but used an AfricanAmerican woman as narrator; and the third used the African-American woman to deliver
the same content but also stressed culturally relevant losses as consequences of not being
tested, such as not getting tested puts your family at risk of losing you to the disease
(Kalichman & Coley, 1995). Compared to characters in the first two videos, participants
rated characters in the third video as significantly more concerned about “Black families
and the Black community” and “women like me,” and as being more “like people I
know.” (Kaluchman & Coley, 1995).

A qualitative evaluation of the Witness Project concluded that because role models
shared faith-based cancer stories in church settings, they were viewed by participants as
having similar cultural values and thus were trusted and deemed truthful (Kalichman &
Coley, 1995). Sixty-three percent of women who viewed the third video and expressed an

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intention to be tested were tested within a 2-week follow-up, compared to 23% who
viewed the ethnicity- and gender-matched video and none who viewed the ethnicity-onlymatched video (Kalichman & Coley, 1995).
Kreuter et al. studied African American women’s responses to a tailored cancercommunication magazine that used behavioral construct tailoring, culturally relevant
tailoring, or a combination of the two to promote cancer screening and prevention.
Behavioral construct tailoring (BCT) assesses an individual’s readiness to change,
perceived barriers, and self-efficacy for changing a given behavior. BCT health messages
are tailored to different individuals based on their responses to measures of key
constructs from theories and models of health behavior change (e.g., stage of readiness to
change, perceived barriers and benefits, self-efficacy) (Kreuter et al., 2004). BCT first
assesses which such constructs are most relevant to each individual for changing a given
behavior, then selects from a large library of information only those messages that
address the person’s unique combination of characteristics (Kreuter et al., 2004).

The culturally relevant tailoring magazines were based on four cultural constructs:
religiosity, collectivism, racial pride, and time orientation, or perception of time. The
baseline questionnaire assessed a range of constructs from theories of health behavior
change, including knowledge, beliefs, perceived barriers, stage of readiness, self-efficacy,
and past behavior related to mammography and intake for cancer prevention and
screening messages that were tailored on cultural constructs alone (Kreuter et al., 2004).
In fact, levels of change among women in this intervention group never exceeded that of
the control group for either mammography or FV intake (Kreuter et al., 2004). Only

15

when culturally relevant tailoring was combined with behavioral construct tailoring did it
emerge as effective. The study found no evidence of effectiveness for cancer prevention
and screening messages that were tailored on cultural constructs alone (Kreuter et al.,
2004).

All elements of the tailored magazines (ie, the tailoring assessment, tailored message
library, graphics, and image library, and design templates) were developed with extensive
participation from African Americans in St. Louis (Kreuter et al., 2004).

Additionally, the chosen sociocultural variables were selected because they have been
found to be important in urban African American populations. As an example, if a
woman indicated on her survey that she thinks African American women should keep up
with issues that affect the African American community, an item on the racial pride scale,
her magazine might also include a story about the particular importance of
mammography to African American women to help reduce race-based disparities in
breast cancer mortality (Kreuter et al., 2004).

While there is an agreement that communication outreach and materials will be more
effective when they are culturally appropriate and consider sociocultural factors for the
populations they serve, little is known about how best to achieve this in health messages
(Sanders et al., 2007). Designing messages to meet the needs of those that are most
vulnerable means taking a closer look at health disparities and identifying which
populations are most at-risk. The link between culture, behavior, and communication
shows improvements for eliciting changes in health-related behaviors, but more research
is needed into designing effective health messages.
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Learning Theory
The theoretical learning literature provides insight into the manner that adults
learn, interpret, and internalize new information. This thesis draws upon this rich field,
which is relatively unexplored to date in research about how to educate the public about
risks from shellfish harvests. This section aims to integrate learning theories with chosen
health communication of shellfish harvest closures.
Social learning theory is a theoretical framework often used in health education in
which cognitive, environmental and behavioral variables are used to explain human
behavior and learning (Turner & Shepherd, 1999). Developed by Albert Bandura (1977)
and colleagues, social learning theory has been used to study health-related behaviors
such as smoking cessation, contraceptive behavior, and exercise (Freudenberg et al.,
1995).

A claim found in social learning theory is that peers can reinforce socially learned
behavior (Turner & Shepherd, 1999). There is some evidence for such claims in the peer
education literature. Kelly et al. (1991) claimed that the method was effective because of
frequent prompting about safer sex by credible peers. Jay et al. (1984) also claimed that
regular reinforcement by peers was a factor in the effectiveness of a health education
program promoting contraceptive use. How social learning theory can influence shellfish
harvesting closures is a gap this thesis aims to address.

Land management units have recently focused their communication strategies on
community outreach activities to influence citizens’ understanding of fuel reduction
practices (Toman, Shindler, & Brunson, 2004). In their study, Toman, Shindler, &
17

Brunson researched the lack of information about the specific types of communication
methods most effective for building support for fuel treatments, specifically seeking
information into uni-directional and interactive communication formats. Unidirectional
approaches are those that typically involve a one-way flow of communication from the
agency to the public, often in a setting unrelated to the message. Interactive programs
provide for either personal contact with agency representatives or on-the-ground learning
experiences (Toman, Shindler, & Brunson, 2004).

Communication activities that target local conditions and public concerns about
the rationale behind specific practices, potential outcomes, and implementation scenarios
are more likely to resonate with participants (Toman, Shindler, & Brunson, 2004).
Although this can be accomplished in varying degrees with many forms of outreach,
programs that allow for interactive exchanges, such as conversations with agency
personnel, are better suited to problem-centered learning.

Bright and Michael (2008) studied the effects of attitudes on natural resource
issues, in their case management of old growth forests. They found that the need to
understand the nature of attitudes of the target audience and the target audience's
perception of the importance of the natural resource issue when developing a
communication program designed to increase knowledge and influence attitudes or
behaviors.
Speaking like a State
In “Speaking like a state: Environmental justice and fish consumption advisories”,
the concept of government agencies failures to communicate effectively to minority
18

populations about fish closures is explored. This article aims to build on the argument
that to remedy environmental injustice related to consumption of contaminated fish,
agencies must change “government-speak” (bland, generic communication) to
communication that is culturally relevant to minority audiences (Chess et al., 2004).
Chess et al. present a historical analysis suggesting why governments may speak
in ways that are not specific and clear to the populations that most need the information.
The argument posed is that communications have been combined into a system to make it
easier to enforce power. This approach ensures that government-speak is uniform in its
nature, even as the population increases in demographic diversity (Chess et al., 2004).
While government-speak may prove beneficial in delivering certain messages, it poses a
distinct barrier for other means of relaying messages, specifically health advisories.

Substantial research has been found indicating that poor, African American, and
Hispanic populations are disproportionately exposed to contaminants that have adverse
health effects, especially to high risk populations such as pregnant women and children
(Conelly et al., 1996). Failing to target audiences, consider cultural and linguistic factors,
and develop clear messages perpetuates the environmental injustice; lower income,
minority populations suffer a greater degree of environmental harm by ingesting more
contaminants from self-caught fish than do white, higher income anglers (Chess et al.,
2004).

In the Pacific Northwest for example, indigenous peoples are exposed to greater
quantities and mixes of contaminants, via different routes, at different frequencies, and in
different contexts than members of the general population (O’Neill, 2003). O’Neill notes

19

the profound differences in the value attached to fish, fishing, and fish consumption by
various indigenous peoples and by the dominant society.

Due to cultural differences, agencies need to ensure that their decisions support
commitments to cultural flourishing for indigenous and other non-dominant groups, as
well as for dominant groups. In regard to fish consumption advisories, “decisions need to
be alert not only to the distributive implications but also to the cultural impacts of a move
to risk avoidance: given differences in various groups' understandings of the practices at
stake, the risk avoidance measures preferred by dominant society evaluators are likely to
be the very ones that encroach most profoundly on the expression of indigenous cultures”
(O’Neill, 2003, p. 57).

While the topic of environmental justice and cultural relevance is a scope beyond
this thesis, it offers insight into the importance of considering those most at-risk in an
advisory or harvest closure.
Risk Communication
It is significant to focus on the development of risk communication materials
aimed at informing populations of both the risk and benefits of consuming fish as part of
one’s diet. Burger et al. examined the efficacy of two risk communication instruments (a
brochure and a classroom lesson plan) to determine whether subjects were obtaining the
desired messages, and whether they would consider changing their fish consumption
behavior. This study differs from others by explicitly looking at Latino women of childbearing age and Latino women who are pregnant women. The overall purpose was to
design and conduct a community based education and outreach program to understand
20

perceptions, so that a program could be designed to reduce consumption of
environmentally contaminated fish and crabs, caught in the Newark Bay Complex by
Latinos.
An additional purpose was to provide the communities with information they
need to make informed nutritional choices (Burger et al., 2003). Again, the method of
consulting the community members themselves in the development of the materials was
utilized to ensure the message was appropriate for the target audience members.

The risk communication message used in this study was more complex than a
regular advisory because the concepts were also specifically addressing pregnant
women’s health considerations. Burger and his colleagues found that most women
exposed to the classroom lesson had a better understanding than those who read the
brochure. It was discovered that 96 % of the women who heard the lesson understood that
it was unsafe to eat fish from the port, compared to 72% of those reading the brochure
(Burger et al., 2003). However, the methods used in this study should be seen as more
than just targeting a specific audience. The success of this outreach was due to the
researchers continuously involving the community and those who communicate health
information directly in the development of materials that will provide the information
needed to make informed decisions about their families’ health.

From these conclusions, the authors suggest that while the data presented may be
specific for the New York-New Jersey area, a study like this may provide further insights
on risk communication for specific populations most at risk. It is clear that participants

21

are more interested and engaged by the use of a live presenter, as compared to
individually reading a brochure.

In a similar study, Engelberth et al. (2013) focused on how state agencies may
assume that risks are the only important factor to address. Risk only communication can
ultimately lead to a lack of awareness of the benefits of consuming fish. The
effectiveness of Maine’s fish consumption advisory in terms of improving knowledge to
pregnant women was evaluated in this study. To measure the effectiveness of the guide,
they designed a mixed-mode (mail and web survey). The questionnaire consists of 55
questions intended to assess awareness of the guide and measure guide-induced changes
in (1) knowledge of the risks and benefits of eating fish, (2) knowledge of the benefits of
omega-3 fish oil supplementation and (3) species-specific fish consumption behavior
(Engelberth, 2013). Results showed that readers increased their ability to make specific
fish-substitutions to minimize risk while maintaining the benefits of eating fish
(Engelberth, 2013). This suggests the advisory has the potential of reducing health risks
while avoiding a drop-in fish consumption.

One caveat that Engelberth et al. point out is the fact that health care providers
may be missing an important education opportunity if they only distribute the guides
without positive and negative. Therefore, lack of engagement between health care
providers, and the women receiving the brochure may decrease the individual's full
understanding of both the risks and benefits of consuming fish. Empowerment through
self-understanding and education can play an important role not only in health awareness,
but also individual empowerment to make changes within the agency systems.

22

Many advisories may provide risk information, but fail to provide the health
benefits. In “Awake at the switch: Improving fish consumption advisories for at-risk
women” researchers examined the benefit of a fish advisory measured by its ability to
inform consumers of the positive and negatives attributes of fish consumption choices.
Teisl et al. (2011) indicated that health benefits of fish consumption are relatively ignored
in health communications about its risks. This study found that the advisory successfully
increased women’s methylmercury-related knowledge, and improved their perceptions of
fish consumption risks. Communication improvements allowed the at-risk population to
make the appropriate choice to switch the kinds of fish they were eating.
In addition, risk communication efforts must take into consideration anglers’
knowledge, attitudes, and beliefs regarding fish and contamination. Agencies such as the
WDOH must not only provide anglers with risks regarding contamination, but allow
anglers to be a part of the process of defining risk (Kalkirtz, Martinez, & Teague, 2008).
Anglers would be consulted during the different phases of designing outreach, and
because anglers are the intended audience receiving the outreach, it is best to include
their perceptions and definitions of what risk looks like. While agencies are charged with
the responsibility of monitoring and communicating closures, the literature around risk
communication calls for the intended audience of the message to play a role in the
development of outreach. This would include defining what risk and benefits in fish
consumption means to them.

In a New Jersey study of state and federal risk communication programs, a
national survey of state public health officials was used to assess the commitment to risk

23

communication outreach. These findings suggest that the risk communication activities of
government agencies in New Jersey were limited and mostly reactive in practice (Chess
& Salomone, 1992). The data further suggest that there are few proactive attempts to
reach out to the public with environmental risk information unless the information is
requested, and even fewer efforts to construct dialogue about risk concerns with the
public (Chess & Salomone, 1992).

In response to the national survey, most respondents said risk communication was
an important agency priority, but said insufficient staff was a major barrier to effective
risk communication (Chess & Salomone, 1992).
Burger’s 2008 study examined knowledge about the benefits and risks of fish in
relation to ethnicity and the degree of knowledge in a general university population in
New Jersey. Subjects were asked open-ended questions about risks and benefits. It was
found that there were ethnic disparities in knowledge about both the benefits and the risks
from fish consumption. A higher percentage of Caucasians knew about the benefits and
risks of fish consumption than others. However, Asian populations knew the least about
risks, and African American and Hispanics knew the least about benefits (Burger, 2008).

There were also ethnic differences in the ability to name fish that are high in
contaminants or low in contaminants. Burger found that although agencies such as the
FDA are concerned that the public will be confused by advisory details, the lack of
details is major component of ineffective communication (Burger, 2007).

24

Conclusion
Several studies discussed in this chapter have shown significant effects of the
impact of message relevance and customization to increasing at-risk populations
knowledge and understandings of health advisories. The focus of this literature review
was on tailored and targeted messages, sociocultural factors, social learning theory,
“government-speak”, and risk communication. These studies address advisories that are
both effective in increasing knowledge, and in addressing both cultural and behavioral
aspects that will influence population perceptions.
As found in the literature around fish consumptions advisories and closures is the
importance of message customization. While it was discovered that message relevance is
crucial in health communication studies around general health concerns, such as smoking
cessation, and weight loss, little has been researched around razor clam harvesters and
beach closure messaging. This thesis aims to address this identified gap in the published
scholarships around health communication intended for razor clam harvesters.

Understanding the effectiveness of outreach tools is beneficial in addressing the
outreach approaches used by public health agencies, such as the Washington Department
of Health, which uses consumption advisories, warnings, and closures. In designing
shellfish closure outreach, agencies such as the WDOH need to determine their targeted
audience. A targeted audience for shellfish closure outreach are the populations that will
be most affected by the closures. For example, the results from this research identified
beginner shellfish harvesters as an identified population requiring targeted messaging and
education in outreach materials. This will be discussed in greater detail in the following
chapters. While this thesis research does not address identifying the populations most at25

risk, it does identify beginner shellfish harvesters as an identified population that might
require targeted health outreach.

To work toward environmental policies that do not benefit one specific culture,
agencies and other decision makers will need to address the effectiveness and intentions
of their messages. In developing targeted outreach, cultural considerations of design,
language, and message implications should be considered. It can be concluded from the
research that there is a need for clear and concise messaging that consider different
populations perceive closures and risk related to shellfish consumption differently.

However, to date, little research has been conducted applying harvesters input
and knowledge to improving public health outreach related to shellfish closures. As
found in the literature around risk communication, is that efforts must take into
consideration anglers’ knowledge, attitudes, and beliefs regarding fish and contamination.
Agencies such as the WDOH must not only provide anglers with risks regarding
contamination, but allow anglers to be a part of the process of defining risk. To date, little
research has been conducted around razor clam harvester beliefs about harvest closures or
areas of improvements the intended audience would like to see. This thesis aims to
identify these key themes.

Additionally, little research around targeted messaging and education for
shellfish populations has been pursued. To address this gap in the published literature,
this thesis explored improving public health outreach based on feedback and perceptions
from razor clam harvesters interviewed on the Washington coast.

26

Chapter 3: Methodology
Depending on the geographic region or location, the act of shellfish harvesting
varies on environmental concerns, laws regarding harvesting, and species of shellfish
collected. This research is aimed specifically at assessing the following: 1) How effective
are the outreach methods employed by the Washington Department of Health’s biotoxin
monitoring program? 2) What are the individual motivations of razor clam harvesters? 3)
How much awareness does the shellfish community have in regards to shellfish illnesses?
In-person interviews were utilized as an approach to answer these questions. Data were
gathered by directly interviewing razor clam harvesters on previously identified beach
locations approved to be open for harvest by the Washington Department of Fish and
Wildlife in partnership with the Washington Department of Health. This section provides
the details of the chosen methodology, limitation to these methodologies, and how these
limitations were addressed within the research. Following the methodology section will
be the coded and themed results.
Interview Methodology
The qualitative methodology used in this study was in-person interviewing of
Washington coast razor clam harvesters. Survey data has been used in previous studies,
such as the WDFW study (Ferris et. al, 2017) that collected data on the amount and
frequency of human consumption of razor clams over the past two years. Data were also
collected on harvest and consumption behaviors including the months in which clams
were eaten, beaches used for harvesting, and whether clams were eaten immediately or
preserved and eaten at a later date (Ferris et. al, 2017). This chosen methodology
however, did not have the goal of finding out common knowledge of closures,
27

motivations, or sources of closure information. Surveys are also limited in allowing space
for subjects to further add personal experiences to data collection. By using interviews,
this research was able to access more detailed information, shining light onto clam digger
understandings of closures, motivations, and where they go to access closure information.
All interviews were conducted after the approval of a Human Subjects Review
application by The Evergreen State College. Interviews were performed with an audiorecorder in order to accurately code and theme data at a later time. All participants
received consent forms and were briefed prior to the interview taking place.

The interviews were semi-structured, meaning that the interviewer decides the
general structure of the interview prepared in advance, but allowing the details and
specific design to be formed during the interview (Galleta, 2013). The key questions to be
asked were designed in advance to provide some guidance and structure to the interviews.
The semi-structured interview approach was further chosen to discover and allow for a
space of individual reflection and experience in regards to clam digging.

The first stage of the interviewing process was identifying locations for interviews
to take place. Once the beaches were chosen, interview dates were matched with the
opening clam digs proposed by the Washington Department of Fish and Wildlife
(WDFW).
Location
In-person interviewing was conducted on identified days that beaches were open
to the public for razor clam harvesting. The beaches selected for interviewing were
chosen based on toxicology test and approval from the WDFW. The WDFW partners
28

with the Washington Department of Health to determine approval dates and locations
based on marine monitoring of toxins in the water. Interviews were conducted on-site in
2017 during the months of January, February, March, and April at the identified beaches
open for harvest.
Razor clams are found primarily on the intertidal coastal beaches (those that are
exposed at low tide) from a +3 foot level to a -2 foot tide level. The WDFW divides the
harvest areas into the following five major management zones (See Figure 2).
● Long Beach from the Columbia River north to the mouth of the Willapa
Bay
● Twin Harbors from Willapa Bay north to the south jetty at the mouth of
Grays Harbor
● Copalis Beach from the north jetty at the mouth of Grays Harbor to the
Copalis River
● Mocrocks from the Copalis River to the south boundary of the Quinault
Indian Reservation and
● Kalaloch from the South Beach campground north to ONP Beach Trail 3.

29

Figure 2. Identified Razor Clam Harvesting Areas (Courtesy of the Washington
Department of Fish and Wildlife website
http://wdfw.wa.gov/fishing/shellfish/razorclams/current.html)

Within these five management beaches there are a total of 58 miles of sandy beaches and
prime habitat for the Pacific Razor Clam (Washington Department of Fish and Wildlife,
2017).

30

Twin Harbors, Mocrocks, and Copalis were approved for harvest in late January
and February, March, and April of 2017. Kalaloch Beach and Long Beach were not open
during the identified study time due to high toxin levels, and as such were exempt from
this study. Since the 2012-13 season, WDFW and Olympic National Park jointly made a
decision to forgo recreational harvest at Kalaloch Beach. These closures have provided
the population on this beach the best chance to recover from the decline it has
experienced since 2009.
Because of concerns with low population abundance of harvestable sized clams,
Kalaloch was not open during the 2014-15 season when domoic acid peaked. During the
2015-16 season domoic acid levels were either above the action levels or at the action
level, just enough to keep this beach closed to harvest. Before a beach can be opened for
the harvest of razor clams, WDOH protocol requires that all razor clam samples collected
from that beach must test under the action level (20 ppm for domoic acid; 80 µg/100g for
PSP; and 16 µg/100g for DSP) on both of the two required sample collections.
Participants
The participants of this study included 29 razor clam harvesters from Copalis
Beach, Twin Harbors, and Mockrocks. The sample size of this study contrasted with the
population size of razor clam harvesters of 281,374 harvesters on all Washington coast
beaches for the 2016-2017 season, as estimated by the WDFW. Washington coast clam
harvesters were chosen for this study for multiple reasons. The first was due to the timing
of my study coinciding with the opening of clam harvesting seasons on the Washington
coast. Razor clam season began for the 2016-2017 year in October of 2016 and ran into
mid-May of 2017. A shellfish/seaweed license is required for anyone 15 years of age or
31

older to harvest clams and oysters during the harvest year, and may be purchased via the
WDFW website, at approximately 600 locations throughout the state, including sporting
goods stores, marinas, convenience stores, and major retailers (WDFW, 2017).
In addition, razor clam harvesters were chosen because domoic acid has caused
several closures on the coast, so the awareness of coast razor clam diggers seemed
appropriate to answer my research questions. The final reason, is also due to the
geographical location, and ease of access to conduct these interviews from Olympia,
Washington. A Washington State clam digging license was obtained from the WDFW
that allowed me to partake in the razor clam harvesting at the identified locations.

The days the three identified beaches were open were matched to in-person
interviewing days, so I was interviewing people when they were there to harvest razor
clams. The geographical location of the three beaches also provided some variety within
my research. To grapple with the issue of self-selection and introducing a bias as much
variety was added to the study as possible. Three beach locations (Twin Harbors,
Mocrocks, and Copalis Beach) were identified as open based on toxicology tests, and as
such, were chosen as the locations of my research. These three beaches may only
represent a small portion of shellfishing in Washington, but for the razor clam digging
season of 2017 were the only three identified to be open, and as such, hold strength in the
data collected. Different days of the week were also chosen to add a variety to the
populations interviewed. Weekdays that interviews took place offered a specific
population of retired, older people, while weekends offered a younger mix of people.
This added diversity within my own study.

32

In addition to in-person interviewing, a flyer requesting feedback from razor clam
harvesters was distributed. Information requesting feedback on the public outreach used
for shellfish closures was offered with contact information to participate in an interview.
These flyers were distributed to as many people as possible on the four open beaches,
posted on community bulletin boards close to the beach, and local grocery stores. Only
one person chose to call and partake in the interview from the flyer request. This method
of outreach was chosen to add variety to the in-person interview methodology. Flyers
offer the opportunity for people to choose for themselves to partake in the interview.
Interview Questions
The interview questions and interview process used in this study were approved by
The Evergreen State College Human Subjects Review Committee. The questions that
were asked of interviewees included:
1) What are your motivations for shellfishing?
2) How long have you been shellfishing?
3) Have closures by a government agency ever prevented you from shellfishing?
4) If so, do you remember the cause(s) of the closure(s)? Where was info found?
5) Are you familiar with domoic acid? Or amnesic shellfish poisoning?
6) Are you aware of the current beach closures on the coast of Washington?
7) Do you check for closures? If so, where do you go to find closure information?
8) Have you ever been ill from consuming shellfish? Or know of someone else who
was ill? If so, did you seek medical help?
9) Are you aware of the Shellfish Safety Map used by the Washington Department
of Health for shellfish closures?
33

10) Have you seen signs posted on beaches for closures? If so, what attracted you to
them?
11) Why do you think people would not comply with a closure?
12) What improvements would you like to see with closure information? What type
of information would you like to see included?
These were asked to answer my three main research questions:
How effective are the outreach methods employed by the Washington
Department of Health’s biotoxin monitoring program?
What are the individual motivations of razor clam harvesters?
How much awareness does the shellfish community have in regards to
shellfish illnesses?
These three questions were chosen to better understand and construct the outreach
messages that will be most effective for its intended audience. I also designed the
methods to contribute to certain sets of literature, for example to illuminate certain
studies about communication of risks and benefits, and targeted outreach in public health
communication. To begin this process, a common understanding of what outreach tools
are being utilized the most is needed. Inquiring into the current awareness of shellfish
illnesses is reflective of the quality of outreach methods currently being used the WDOH.

In addition, this research looked at why razor clam harvesters choose to shellfish.
Motivations have the potential to offer insight into the community itself. As found in the
literature around risk communication, is the importance of understanding and
incorporating harvesters’ knowledge, attitudes, and beliefs around fish and contamination
34

(Kalkirtz, Martinez, & Teague, 2008). Allowing outreach to be tailored for individuals, or
targeted for groups of clam harvesters. Motivations also provided insight into the amount
of beginner shellfish harvesters, and thus creates a target audience of outreach.
Coding
After transcribing by typing each of the 29 recorded interviews in Microsoft
Word, coding was used as a device to thoroughly analyze the results. Coding is the
process of sorting, categorizing, synthesizing and evaluating collected qualitative data to
understand the meaning of the text (Clifford & Valentine, 2003). The coding method
used for this research was to read through transcriptions and highlight trends and major
themes directly related to my research questions. Each trend and major theme became a
code, and a list of the codes found in the transcriptions was created. Some examples of
the codes were, “Perceived Causes,” “Sources (of closures information),” “Motivations,”
and “Improvements (to outreach)”. The codes were derived from my research questions
and extensive literature review of the topic.
Limitations
While conducting and designing this research, a few limitations arose. To add as
much variety to the research methodology as possible, I selected different beach harvest
locations identified to be open, days of the week, months, and times coinciding with lowtide to conduct interviews. While this study had a sample size of 29 harvesters, this is not
representative of the entire shellfish population, and should be noted. Responses to
interview questions are limited to the 29 interview subjects that participated in this
research.

35

Self-selection bias of interview subjects also comes into this research. I positioned
myself on beach harvest locations to access razor clam harvesters present that day.
Individuals were approached based on their proximity to myself on the beach, and were
selected based on their willingness to participate, proximity to my location, and their time
to devote to answering my questions.

Flyers requesting feedback from razor clam harvesters were also distributed at
local grocery stores, fishing retails shops, and public parks close to the identified beach
locations. Only one participant replied to the flyer request, and participated in a telephone
interview.

36

Chapter 4: Results: The Voice of Razor Clam Harvesters
The purpose of this research was to contribute to state agencies developing
outreach tools intended to reach their audience of shellfish harvesters in Washington
State. This study’s research of coastal razor clam harvesters intended to discover
commonalities expressed in motivations, knowledge, sources of closure information, and
improvements as expressed from the intended audience of outreach. In this chapter,
results from in-person interviews are synthesized and broken down by the questions
asked and subject matter responses. Narratives are included to establish razor clam
harvesters’ motivations, knowledge of closure causes, where they go to locate closure
information, and improvements they would like to see within outreach communication.
To convey my research findings from the interviews, quotes were selected that addressed
these topics. Chapter 5 will include a discussion of these findings, as well as
recommendations to improve current outreach used by agencies such as the Washington
Department of Health and the Department of Fish and Wildlife.
Motivations:
What are your motivations for harvesting razor clams?
A New Experience or Hobby
The first question inquired of razor clam harvesters was their motivations for
razor clam digging. As derived from the literature review, motivations provide more
information into designing outreach tailored for individuals, or targeted for groups of
razor clam harvesters. Personal motivations ranged from experiencing a new activity to
teaching a friend or loved one the techniques of catching a razor clam.

37

Out of the 29 interviewed, five reported that the activity was a new experience
that they were trying for the first time. Teaching or learning razor clam digging from a
friend or family member was also mentioned as a motivation for beginner harvesters.
This is an insightful motivation because it provides information in to the level of
knowledge the clam harvester has going into the activity. Other motivations included
simply being with family, and sharing a hobby. The following transcribed passages from
three interviews depict the harvesting motivation as a new activity, or one to be shared
with friends and family.

We enjoy eating them and catching them. We come as a family, and do it
together. I look forward to coming out with the entire family on the first day of
the season.

I came out here with my boyfriend and his family. He's been teaching me how to
do it all. So yeah, I guess it's a learning experience. Something new to try out. A
new hobby. It can be intimidating. Like, I had no clue where or what to do once
we got here. I didn’t even know the proper clothing to wear. That’s pretty bad,
isn’t it?

Today I am here with my daughter. This is our second or third time coming to the
beach to hunt for clams together. I have pretty fond memories of my dad bringing
me out. In some sense, I wanted to recreate those memories with her. Some part
of me has the intention of hoping she’ll do the same with her kids. It’s a very
nostalgic experience.

38

Motivations are important to understand because they aid the process of creating health
messages intended to reach different audiences who may hold different motivations and
knowledge levels of clam digging. For example, if more people are razor clam digging as
a new hobby, then more basic beginner outreach could be designed by agencies such as
the WDOH and WDFW. The following passage expresses razor clam digging as a new
experience.

I have never done it before, and someone native of Washington here said if
you’ve never gone clam digging you have to go at least once. So, I knew it was
kind of a bucket list thing to do. And it’s one of the unique things that you can do
here; you can't do it anywhere else.

Another finding is that the five razor clam harvesters who said it was their first-time
harvesting clams were originally from another state outside of Washington. The
following passages illustrate the motivations to harvest from the perspective of
individuals non-native to Washington.
I was curious about how it all worked, so I started tagging along. I’m from Ohio,
and they don’t have razor clam digging there, so I was mostly curious about the
sport itself. I had never used a clam gun, so it was all really new and fascinating.

I grew up in Rhode Island. We have oysters and clams, but nothing comparable to
shellfish harvesting out here. The entire sport was like learning how to ride a bike.
No idea shellfishing required a certain technique and procedure.

39

I guess not being native to Washington I felt I needed to read up more on the topic
of shellfish. It seems most of the people you bump into are born and raised in this
area, they know what to look for, and I didn't feel that way. Yeah, I had to read up
a little more than most, because where I'm from they don't have shellfish, so all
these rules and licenses were a lot for me.

Razor clam harvesters from out of state could coincide with lack of knowledge of
closures if they are from a region unfamiliar with shellfish harvesting safety. An
identified area of improvement could be designing separate outreach targeted towards out
of state beginner harvesters.
Nature
Other motivations included experiencing nature, and being part of the
surroundings. 8 out of the 29 said being in nature, or at the beach was a motivation for
harvesting razor clams. Additional motivations included experiencing the nice weather,
and taking in the vista views of the Pacific coast beaches. Also mentioned, was the fact
that bad weather could be a deterrent to harvesting for the day. Appreciation of nature can
be a large motivator for clam digging.
I enjoy the coastal views. Nothing like the Pacific coastal views, and the wildlife.
I saw a bald eagle earlier today. It's unreal the amount of beauty you see on a day
like today. So yeah, some of it is to be a part of nature, experience that, be a part
of it in my own way today. Plus, clam digging is a tradition of the culture in
Washington It dates back, and I want to be a part of that cultural experience.

40

Tradition
A motivation coupled with experiencing nature was the traditional aspect of razor
clam harvesting. Nine said the tradition of razor clamming in Washington was a
motivation to continue harvesting. Passing on the tradition to a family member was also
mentioned as a motivation for harvesting razor clams. The value in the traditional aspect
of shellfishing was mentioned as a cultural aspect of living in the Pacific Northwest.
For me, I kind of feel like I’m a part of the whole system. You know, when you
think of the Native American tribes out doing their clam digging and gathering. I
want to feel a connection to the land, and the ocean.
It’s beyond a recreational activity. We’ve been coming to the same beach
generation after generation. I even use the same shovel my grandfather used to dig
clams back in the 50’s. Clamming holds a cultural aspect tied to the tribes who
have been around long before. I’m mindful of the traditional side, the patience
and tranquility of being present. I see that evident with the traditional tribal side
of shellfishing, too.
A Meal
A very basic motivational response was preparing a meal out of the harvested
razor clams. 8 harvesters replied that preparing the razor clams for a meal was a
motivation for shellfishing. One harvester replied to my inquiry into motivations with a
one word response of “dinner.” Replying with a food source as a motivation was
followed up with a subsidiary question inquiring how important clams are as part of their

41

diet. Out of the 8 that replied with food source as a motivation, none said they were
significant to their diet, or culturally important.
Oh, not that important. It’s a luxury I guess, if that’s the way you want to put it.
Or a privilege, you know, to come to the beach and catch clams to take home for
dinner. You don’t get them all the time. They’re really tasty. I fry them up in hot
grease. Pretty crispy.
I’ve perfected the razor clam chowder recipe. That’s what gets me out here with
my husband. I go home and make us a big batch of chowder. I leave the cleaning
and removal of the shell to him, but I got that recipe down. Same recipe my
grandma used. Nothing better than chowder fresh from the ocean, you just can’t
beat that.
Knowledge of Closures:
Can you tell me the cause or causes of recent harvest closures?
Domoic acid
Interviewees were also asked if they were aware of the causes of current or recent
harvest closures. Since reasons for closures frequently vary, a variety and combination of
causes for closures were received. Eleven said the cause was due to toxins or chemicals
in the water, but did not specifically say domoic acid as the biotoxin causing closures.
Five mentioned domoic acid as a specific closure cause. When domoic acid was used as a
response to a closure, a subsidiary question was asked where that information was
obtained. The following passages depict razor clam harvesters’ understanding of a
closure based on toxicity levels, and where that information was obtained. In these cases,

42

the WDFW was used as a source of toxicity information. The complete sources of
findings will be shared later in the chapter.
The website [Department of Fish and Wildlife] talked about that they checked
some toxin, something toxic that the shellfish can pick up from the ocean, and
they test so many, and if they test clear, then that’s the beach they open from what
I was reading. And the beaches that they stay closed is because they’re still testing
some high level of toxicity in the clams, so they don’t want to open it to the
public.

I checked on the website the Department of Fish and Wildlife provides. I been
keeping up with the closures on there this season.
Pollution
Pollution was discussed as a closure reason five times during interviews. Pollution
was used as a reply with other causes for closures such as increased populations
shellfishing and rural run-off. Bacteria, red tide, and algal blooms were also mentioned as
causes of a harvest closure. Pollution was also considered as a cause affecting the number
of clams available.
In the ‘50s and ‘60s and even the ‘70s we never heard of toxic clams, they didn’t
exist. Well apparently, rural pollution, or whatever, the way things have changed,
now we got toxic water that the clams eat and of course that affects them.
Razor clam populations
Low razor clam population counts was also brought up as a possible reason for
beach harvest closures. 10 out of the 29 razor clam harvesters mentioned razor clam
43

populations as a cause for a closure. During the selected days this research took place in
late January, February, March, April of the 2017 season, Kalaloch was closed due to low
population counts. For the first time since 2012, Kalaloch Beach was tentatively
scheduled to open on January 8 and 9 for digging, but was unfortunately not included in
this data collection. Dwindling clam populations was a common theme expressed by
razor clam harvesters for closures. The following passages depict concern around razor
clam populations as a closure cause.
It’s changed over the years. It didn’t matter which beach you went to, you always
got big clams back in the ‘50s and ‘60s. But as the freeway came in and more
Seattle people came down here to dig, well you can see what happened. When I
started digging there was no such thing as a limit for clams. Then it went 60 and
worked its way down the current limit of 15.
Well I guess it’s for clam populations, keep them high enough so people can leave
with a decent number. I’d say the population increase in trash and pollution, that
doesn’t help the clams any. So, it’s like a cycle, more people, more trash, more
pollution in the environment, less clams, but still more people wanting clams. It’s
a vicious cycle that’s been going on, I don’t know what it will take to end it.
Tribal sovereignty
One response from interviewees regarding causes of closures was Tribal
sovereignty rights to shellfishing. A few razor clam harvesters expressed concern and
confusion in regards to understanding when the beach is closed to non-Tribal harvest.

44

Well I tell you what, we drove all the way down to Roosevelt Beach recently only
to find out it was closed to the harvest of non-Tribal members. I don't recall
hearing anything about that mentioned on the news or the website. That was a
wasted day; we made that drive only to have to turn back. Why wasn't that
mentioned anywhere? They need something mentioning the Tribal harvest on that
website. It gets confusing to try and follow all these closures.

Knowledge of the cause of a closure is reflective of the outreach and education
being used by the Department of Fish and Wildlife and the Department of Health. The
lack of understanding of the cause of a harvest closure can be identified as an area of
improvement for public health messaging and outreach. This will be discussed further in
the following chapter.
Sources of closure information:
Do you check for harvest closures? If so, where do you go to find closure
information?
Asking razor clam harvesters where they go to locate closure information was a
key question asked during interviews. This question was posed to gauge what tools
shellfish harvesters utilize for information related to harvest closures, as well as where
improvements can be made by agencies issuing closures.
The Washington Fish and Wildlife website
When asked where they check for harvest closure information, out of the 29 razor
clam harvesters interviewed, 27 replied with simply the “website.” When asked for
further information on which website, the Washington Fish and Wildlife website was
45

mentioned. The WDOH website was not mentioned as a website used for closure
information. It was also found that information on domoic acid was found via the WDFW
website.
Newspaper, Local News, Word -of-mouth
Along with the WDFW website, a source of closure information included
newspapers, local news, and word-of-mouth from fellow clam harvesters. Newspaper
messaging of closures was mentioned from harvesters on two different occasions, local
news once, and word-of -mouth from fellow clam harvesters on five different occasions.
Down here, they print it in the local newspaper, we grew up, my wife and I both
grew up in Aberdeen, but now we live in Belfair, which is up by Shelton, so they
don’t get it in the paper like they do down here. Unless it’s a big deal, so you got
to check it online. My brother from down here calls me, or I trust somebody will.
I’d like to see more information in the Tribune and Olympia on water quality, just
a weekly update if possible would be helpful.
The Shellfish Safety Hotline number
A response received from razor clam harvesters on three different occasions was
use of the biotoxin hotline number as a source of closure information. The Shellfish
Safety hotline number is a tool developed by the WDOH, that allows harvesters to call
the number to receive updated closure information.
We just call the Hotline number. When we went shellfishing on the Puget Sound
we called that number. Pretty helpful when you’re already out away from the

46

computer and wondering if the site is actually still open, because those things
change overnight. I always keep my phone handy when I come out to the beach.
Shellfish Safety Map:
Are you aware of the Shellfish Safety Map used by the Department of Health for
shellfish closures?
The Washington Department of Health has been pushing for more people to
utilize their online shellfish safety map (Figure 3) as a source of closure information. To
spread more awareness of this useful tool I passed out outreach material developed by the
WDOH during interviews. Out of the 29 people interviewed none responded with being
familiar with the Shellfish Safety Map. This tool is only available online, but can provide
specific beach location information regarding causes of closures. This is an identified
area for the Department of Health to consider in their public outreach attempts.

Figure 3: Shellfish Safety Map
(courtesy of the WDOH https://fortress.wa.gov/doh/eh/maps/biotoxin/biotoxin.html)
47

Reasons for not following harvest closures:
Why do you think razor clam harvesters would not comply with a closure?
Reasons why other razor clam harvesters may choose not to follow harvest
closures was investigated, to provide insider views. Razor clam harvesters can provide
more awareness into closure compliance because they are directly related to the activity,
and hold more familiarity with the community of shellfish harvesters.
Distrust
A common theme expressed by five of the participants was that fellow razor clam
harvesters may feel that they know best when to harvest clams due to their personal time
and experience with harvesting. Razor clam harvesters felt that some harvesters may feel
that the insider knowledge and understanding creates a better perception of when to
harvest than the issued closure by agencies. Distrust or trusting one’s own knowledge of
closures is expressed in the following interview excerpts.
I’d probably think they’d do that because they don’t always trust that the level of
toxicity might be real. Or they think that it’s hit or miss, and they’re just going to
take their chances or that their bodies or whatever will adjust or accept it, and
there won’t be enough to do anything health wise to people. I think they just kind
of ignore that, kind of like, knowing that smoking causes cancer, but you smoke
anyway.
It could be any reason, maybe they think they know what’s best when it comes to
catching clams, or whatever. A lot of the shellfishers out here have been doing it
their entire lives, and they feel like that should constitute enough in determining if
48

they’re safe enough. People are stubborn, and old, they don’t want someone
coming in and telling them how they should be doing it.
Lack of Knowledge
Lack of knowledge or understanding of the possible causes of a closure was
offered as another reason harvesters may choose not to follow a closure.
Some folks just don’t understand the severity of the situation. They don’t know
about toxin levels, or the harmful health effects to people. Others choose to be
ignorant to the fact that shellfish are tied to serious health concerns. We need to
consider all the different populations who do shellfish, because that brings to the
table all kinds of reasons to dig shellfish. Maybe once we take into consideration
all the different shellfish populations that will change how we do this stuff.
Too much information
The various factors that affect a harvest closure was suggested as overwhelming
harvesters, and cause for ignoring a harvest closure.
To some degree, the public must be responsible too, and make sure that they
know what they’re doing. I can see people feeling overwhelmed by the toxin
names, or causes, but, you can’t make people care about their well-being. There’s
some ownership of that responsibility on the people who choose to come out here.
If you’re not a local or not as familiar with closures it can be overwhelming, I
know I have had to read on the website [WDFW] a few times just to double check
it was safe for us to come out. It’s a lot to remember and take in.
Identified Improvements:
49

What improvements would you like to see with closure information? What type of
information would you like to see included?
Improvements to closure information was asked about, to provide more insider
knowledge from the audience that would be receiving the closure information. This was
an important question to ask of razor clam harvesters, because it reflects the wants and
needs of the targeted audience members.
Expand Outreach
One common theme received from interviewees was requesting more closure
material in varying outreach forms. The forms of outreach included printed materials
such as brochures, newspaper articles, and signs on the beach mentioning upcoming
closures. Accessibility to internet based tools was brought up, with an expressed concern
for expanding beyond the outlet of the internet.
They need to expand beyond that website, because, you know what, some
individuals don’t have access to the internet, or even know about it in the first
place. Are newspapers a thing of the past? Why don’t we have more updated
closures dates listed in the local papers, or mentioned in the news? Or,
distributing information with that license when you purchase it. That, right there,
is a good start.

You know that's tricky. I think you guys already do a nice job of getting the
information out there, it's just a matter of getting people to care enough to
understand the dangers of coming out here and harvesting when those toxins are
in the water. Maybe if you had a person out here on the beach, like yourself,
50

approaching people and having civil conversations simply explaining the dangers.
Maybe that would help? Or maybe when you mail out their harvest licenses
sending out little pamphlets going over the basics. But then again you're still
going to have people who want to do their own thing. The only way to make them
care is to let them get sick on their own, and then they'll learn. Maybe that's what
it'll take.
Brochures with Licenses: A beginner’s guide
A discovered theme found from interviews was providing how-to guides of
information for beginner harvesters. A further suggestion was to offer a brochure
explaining the different causes of closures, and where to access closure information,
including information regarding the Shellfish Safety Map, and other tools used by the
WDOH, such as the biotoxin hotline number. Brochures were recommended to be
handed-out or mailed with purchased licenses.
Maybe handing out leaflets with closure information in them, or the reasons
they’re closed, like mentioning domoic acid. Another thing is being from out of
state, I feel like most diggers out here today are from Washington, and are already
familiar with the way things work. It sure would be nice if they had a section for
out of towners. ‘Cause a lot of people not native aren’t as familiar, so maybe
creating some messages just for the less knowledgeable fishers.

When you buy your license they probably should help you a little bit. But they
probably can’t possibly know everywhere that they sell them. But maybe even
give a brochure when you get the license? Maybe they could give you the

51

Department of Health magnet, how about that? Have those magnets at all the
places where they sell licenses for shellfish.
Beach Signage
Lot of it’s on the computer, as long as my computer works because we live out in
the sticks. I would assume if I forgot to check the computer that there would be a
sign at the beach. They’re going to do Copalis Beach on Friday, Mockrocks on
Saturday, Copalis on Sunday. Anyways they’re switching the dates, and they
made a note of that, make sure you check you’re on the right beach. Well I’m
hoping there will be a sign on the beach that says closed today because somebody
is going to forget, and it’ll get confusing. And we’re usually here two hours early,
and if you’re the only one on the beach you’re going to wonder if you’re at the
right beach or not.
It would be nice to have something posted on the beaches, but I know it’s an
awfully long beach, but maybe at all the driving entrances they could have just
something temporarily up like clam digging is open this week, or clam digging is
closed due to high levels of blah blah toxicity. Something that could be
removable. I did notice there were signs that you can’t drive on the beach, during
certain months. So maybe they could have more signs. And also a lot of places
will have a red flag up if waves are too hard, yellow flags for something else.
Maybe they could have some kind of visual posting to at least making people
curious to what that might be and they can find out.

52

Shellfish Safety Map
After informing individuals of the Shellfish Safety Map, many thought more
outreach should be used in getting that tool to the public. This is a tool only available
online, but valuable when trying to decide if a particular beach is open to the harvest of
shellfish. It was suggested that the outreach tools (magnets, pencils, small cards) handed
out during interviews also be provided with the brochure when purchasing or receiving a
license.
Well we didn’t know about the Shellfish Map. I had no idea that had something so
comprehensive developed. That is especially helpful for us in future digs even out
on the Sound, or the Hood Canal.
Conclusion
The qualitative data from these interviews depict clear motivations, perceptions of
closures, and sources of closure information. These findings were organized around the
interview questions to illustrate common themes expressed in each section. Through
analysis of the interviews, these data have provided insight into the perceptions and
understanding of closures by 29 razor clam harvesters. The data demonstrate that five out
of the 29 razor clam harvesters are approaching the activity from a purely new
standpoint, or leaning on other experienced shellfish harvesters for guidance. Sources of
closure information are primarily coming from the WDFW website, but many are still
utilizing word of mouth, newspapers, and the biotoxin hotline number.
A diversification of outreach beyond the internet-based tools was further
requested by interview subjects who felt this was not representative of all harvesters, or

53

individuals without access to the internet. It was further expressed that tools such as the
local newspaper and biotoxin hotline number are still being utilized, and could serve as
sources beyond the internet. An identified area for the WDOH, is improving outreach for
the Shellfish Safety Map, as none of the harvesters expressed an understanding of where
to locate, or use the tool. State agencies such as the WDOH and WDFW can use this
information to create public health outreach messages that are catered to the motivations,
experience-level, and wants expressed in these interviews.

54

Chapter 5: Discussion and Conclusion
What are your motivations for harvesting razor clams?
As shown by the interview results, individual motivations, knowledge of closures
and causes, and experience levels for razor clam harvesters vary. A key theme that
emerged from this research was that harvesters are approaching the activity from a purely
new standpoint, often relying on the knowledge of more experienced friends or family
members to teach them the ins and outs of razor clam harvesting; this also included
getting information on beach closures. Of the participating 29 razor clam harvesters in
this research, five were harvesting for the first time, and reported unawareness of closure
causes, or where to go to check for harvest closures. This is an identified limitation and
area of improvement for agencies, such as the Department of Health, which designs
public outreach materials.
Expanding public health messages to be clear for beginner harvesters is a
significant step forward in reaching all audience members. Currently, the WDFW offers
online YouTube tutorial videos teaching the basics of harvesting razor clams. However,
this can be expanded by incorporating more beginner how-to outreach material, such as
pamphlets expressing gear requirements, closure information, where to find closures, and
causes of closures.
Another key theme that emerged in the motivations section was that many
harvesters were from out of state, and were not as familiar with Washington State laws
and regulations regarding razor clam harvest closures. This can be done by designing
outreach targeted at out of state harvesters, and including the brochure or pamphlet with
the license when bought by the harvesters.
55

As pulled from the literature review, targeting the health message to your
audience can produce more compliance with the health advisory. Knowing that beginner
harvesters are attempting to understand the process of razor clam harvesting leads to
developing outreach targeted to address their needs. This has the potential to mean
including messaging targeted at the emerging themes discovered from the interviews,
including “Perceived Causes” “Sources (of closures information)” “Motivations” and
“Improvements to outreach”.
Can you tell me the cause or causes of recent harvest closures?
Knowledge of the cause of a closure is reflective of the outreach and education
being used by the Department of Fish and Wildlife and the Department of Health. As
mentioned, the WDOH currently uses a bi-lingual recorded hotline number for biotoxin
closures, an interactive online shellfish safety map, shellfish danger, warning, and closure
signs posted in eight different languages, media publications, including a descriptive
educational section offering biotoxin education on their website, and an online biotoxin
bulletin updated daily with closure information. The highly varied responses and
understandings of the closure cause can be identified as an area of improvement for
public health messaging, education, and outreach. The razor clam harvesters interviewed
expressed a spread on the causes of a closure. As far as the awareness level goes in to
closure causes this research found 11 responses tied to toxins or chemicals, but only five
expressed knowledge of domoic acid as well as symptoms related to exposure.
Pollution, bacteria, red tide, and algal blooms were included as potential causes of
a harvest closure. Closures can be put into effect for all of the mentioned reasons, thus
making it difficult to communicate the many causes to protect public health while also
56

distinguishing the differences between them. Currently, the WDOH and WDFW offer
sections on their websites including information regarding the closure causes. Because
the websites are restricted to an audience that utilizes or has access to internet this may be
an identified area needing a diversification. There was an expressed theme for more
forms of outreach including printed materials such as brochures, newspaper articles, and
signs on the beach mentioning upcoming closures. Accessibility to internet based tools
was brought up as a concern for many harvesters’ due to the fact that beach closures can
change so quickly. A request for diversification beyond the internet-based tools was
requested from harvesters.
Do you check for harvest closures? If so, where do you go to find closure information?
A trend found from this research was that 27 out of 29 of harvesters interviewed
were going to the WDFW website for closure information. This is an interesting find
because it was also expressed that a need of diversification beyond online tools was
needed. The WDOH website was not mentioned as a source of closure information for
coastal harvesters, but the WDOH tends to focus more on the Puget Sound area than the
coastal region of shellfishing.
While the WDOH website was not mentioned, the WDOH biotoxin hotline
number was mentioned as a tool used for closure information. The harvesters expressed
an ease of accessibility with the hotline number, especially to information that can change
overnight. The hotline number could potentially offer information on accessing the
Shellfish Safety Map for additional closure information.
Theories related to how individuals learn from peers is useful for the purpose of
this research. Interviews conducted revealed that beginner harvesters were learning from
57

family members and peers who were more experienced with razor clam harvesting. It was
also found that peers served as sources of closure information for beginner harvesters. It
will be important to include social learning theory in designing outreach messages
targeted to meet the needs of those most susceptible to illnesses. This theory offers
insight into how messages may be interpreted for different groups, as well as how
learning from others influences the process.

Are you aware of the Shellfish Safety Map used by the Department of Health for
shellfish closures?
The lack of awareness of the WDOH Shellfish Safety Map was one of the most
telling aspects of the conducted interviews. Out of the 29 harvesters interviewed none
expressed an understanding of what the Shellfish Safety Map entailed, or where to find it.
This presents a focus area for the WDOH in furthering outreach around this chosen
method. It was suggested from the interviews that the outreach tools for the Safety Map
(magnets, pencils, small cards) distributed during interviews also be provided with the
brochure when purchasing or receiving a razor clam license from the WDFW. This is a
tool focused on the Puget Sound area, but has the potential to address the needs of the
coastal harvesters.
Why do you think razor clam harvesters would not comply with a closure?
A discovered theme that matched the literature review was the distrust of state
agencies in health advisories. Razor clam harvesters felt that some harvesters may feel
that the insider knowledge and understanding of shellfishing creates a better perception of
when to harvest than the issued closure by agencies.

58

The learning theory literature describes the importance of creating a trusting and
safe environment to facilitate effective information exchange (Knowles et al., 1998).
Such an environment is critical to encourage active participation where an exchange of
ideas and experiences can occur. Learning theory concepts indicate that adults take a
problem-based approach to learning, have a range of prior experiences and knowledge
levels, and are more likely to believe information from a trusted source (Toman, Shindler,
& Brunson, 2004). As found in their study regarding trust and the internet, findings may
suggest the public has become wary of information from this largely unregulated source
and reflects that each day most of us are overloaded with unsolicited messages and
information (Toman, Shindler, & Brunson, 2004).
Lack of knowledge or understanding of the closure cause was offered as another
reason harvesters may choose not to follow a closure. This presents an obstacle in
presenting clear and concise information to the public while also covering the safety and
health concerns.
What improvements would you like to see with closure information? What type of
information would you like to see included?
From the interviews conducted, there was a call for a diversification beyond the
current methods of outreach, including the internet-based tools. This included
information in hard-copy form such a brochures, pamphlets, magnets and small cards
with the Shellfish Safety information. The distrust matched with the need for a
diversification in the outreach materials points towards designing messages more closely
linked to hard-copy forms.

59

The request for diversification of outreach materials, also means finding a balance
of the information regarding risks and benefits for consumption of razor clams. As found
from the Literature Review, risk communication efforts must take into consideration
anglers’ knowledge, attitudes, and beliefs regarding fish and contamination. They must
not the receiver of the outreach to be a part of the process of defining risk (Kalkirtz,
Martinez, & Teague, 2008).
Brochures with beginner information, including the different causes of a closure
were recommended to be handed out or mailed with purchased razor clam licenses. This
will require the WDOH to work with the WDFW, who distributes the licenses via their
website, at approximately 600 locations throughout the state, including sporting goods
stores, marinas, convenience stores, and major retailers (WDFW, 2017). The
recommended brochures offer the opportunity to try different styles of outreach
messages, including expansion beyond internet based tools.
For example, using a targeted message approach in the brochure would include
messaging and education aimed towards a specific audience. Based on the data collected
from interviews, outreach targeted at beginner- out of state- harvesters would be a good
start. Other themes that emerged within the beginner shellfish harvesters was lack of
knowledge as to where to go for information regarding beach closures, and causes of
closures.
Conclusion
This research has explored where razor clam harvesters go to receive shellfish
closure information, their perceptions of closures, motivations, and the ways in which the
Department of Health can further improve public health outreach methods to better
60

address their needs. This research found that participants not only had mixed perceptions
of closures, but were utilizing different sources of outreach used by the WDFW, and
WDOH. An overwhelming majority of participants were using the WDFW website as a
source for closure information, yet there was a call for a diversification beyond internetbased tools. It was also found that none of the participants were familiar with the
Shellfish Safety Map, and as such, is and identified area of outreach that needs
improvement for the WDOH. Future outreach for the Shellfish Safety Map was
recommended in more hard-copy forms such as brochures, small cards, or magnets
promoting the tool.
Additionally, this research found that razor clam harvester’s non-native to
Washington were motivated to try the hobby for the first time. This offers the WDOH a
targeted audience for designing messages to meet the needs of those that are new to the
area and the activity. Beginner harvesters requested a need for the basics such as causes
of closures, and where to go to find closure information. Other potential messages should
include information to tools and gear needed for the activity.
This research suggests that harvesters have a mixed understanding of the causes
of harvest closures. While a closure may due to different causes (low clam counts, high
levels of DA) there needs to be more outreach with information regarding DA-exposure.
Found from the literature around risk communication, there needs to be a balance of the
risks and benefits to consuming shellfish. The process of balancing risks and benefits of
fish consumption, also includes understanding how the intended audience views and
defines the two concepts. Future outreach should incorporate these concepts in designing
their messages and education. Ultimately, the goal of an advisory is not to scare
61

individuals away from harvesting and eating shellfish, but to provide clear and concise
information that allows the public to make healthy choices.
In the face of increased shellfish harvest closures related to domoic acid and
increased levels of exposure, these individual harvesters can add to the development of
sufficient public health outreach. Providing targeted outreach to meet the needs of those
that will be the most affected can fulfill state agencies responsibility of protecting public
health.
Suggestions for Future Research
As identified in the literature review section, there is a need for creating culturally
relevant public health outreach. The scope of this thesis did not identify the specifics of
demographics harvesting razor clams, but offers the opportunity for future research in
identifying the needs, perceptions, and motivations of minorities related to closures.
While the WDOH has developed beach closure signs in different languages, the approach
used to implement and distribute outreach will require a close-eye to producing culturally
relevant materials. Asking how state agencies can develop culturally relevant and
appropriate outreach in razor clam harvesting closures is a suggested area of future
research.
In developing targeted health outreach to out-of-state beginner harvesters, more
information will be needed surrounding designing the outreach. I propose a similar study
of in-person interviewing and possible focus groups to gather data around the perceptions
and needs of this population. In addition, examining the success of a beginner-brochure
has the potential to improve the design of future educational and messaging techniques.

62

In moving forward with public health outreach and messaging, agencies in Washington
State are offered a unique opportunity to be a leader in designing effective materials.

63

References
Bill, B. D., Cox, F. H., Horner, R. A., Borchert, J. A., & Trainer, V. L. (2006). The first
closure of shellfish harvesting due to domoic acid in Puget Sound, Washington,
USA. African Journal of Marine Science, 28(2), 435-440.
Beehler, G., McGuiness, B., & Vena, J. (2001). Polluted fish, sources of knowledge, and
the perception of risk: Contextualizing African American anglers’ sport fishing
practices. Human Organization, 60(3).
Bright, A. D., & Manfredo, M. J. (1997). The influence of balanced information on
attitudes toward natural resource issues. Society & Natural Resources, 10(5), 469483.
Bull, F. C., Jamrozik, K., & Blanksby, B. A. (1999). Tailored advice on exercise—does it
make a difference?. American journal of preventive medicine, 16(3), 230-239.
Burger, J., & Gochfeld, M. (2008). Knowledge about fish consumption advisories: A risk
communication failure within a university population. Science of the total
environment, 390(2), 346-354.
Campbell, M. K., Tessaro, I., DeVellis, B., Benedict, S., Kelsey, K., Belton, L., et al.
(2002). Effects of a tailored health promotion program for female blue-collar
workers: Health works for women. Preventive Medicine, 34, 313–323
Chess, C., Burger, J., & McDermott, M. H. (2005). Speaking like a state: Environmental
justice and fish consumption advisories. Society and natural resources, 18(3),
267-278.
Chess, C., & Salomone, K. L. (1992). Rhetoric and reality: Risk communication in
government agencies. The Journal of Environmental Education, 23(3), 28-33.
Clifford, N., & Valentine, G. (2003). Key methods in geography Sage.
DeWeese, A. D., Kmiecik, N. E., Chiriboga, E. D., & Foran, J. A. (2009). Efficacy of
Risk‐ Based, Culturally Sensitive Ogaa (Walleye) Consumption Advice for
Anishinaabe Tribal Members in the Great Lakes Region. Risk analysis, 29(5),
729-742.
Engelberth, H., Teisl, M. F., Frohmberg, E., Butts, K., Bell, K. P., Stableford, S., &
Smith, A. E. (2013). Can fish consumption advisories do better? Providing benefit
and risk information to increase knowledge. Environmental research, 126, 232239.
Ferriss, B. E., Marcinek, D. J., Ayres, D., Borchert, J., & Lefebvre, K. A. (2017). Acute
and chronic dietary exposure to domoic acid in recreational harvesters: A survey
of shellfish consumption behavior. Environment international, 101, 70-79.
Freudenberg, N., Eng, E., Flay, B., Parcel, G., Rogers, T., & Wallerstein, N. (1995).
Strengthening individual and community capacity to prevent disease and promote
health: In search of relevant theories and principles. Health Education
Quarterly, 22(3), 290-306.
64

Galletta, A. (2013). Mastering the semi-structured interview and beyond: From research
design to analysis and publication. NYU Press.
Grant, W. S. (2015). Shellfish aquaculture in Washington State. Final report to the
Washington State Legislature, 84.
Gregory, D., Johnston, R., Pratt, G., Watts, M., & Whatmore, S. (Eds.). (2011). The
dictionary of human geography. John Wiley & Sons.
Holloman, E. L., & Newman, M. C. (2010). A community-based assessment of seafood
consumption along the lower James River, Virginia, USA: potential sources of
dietary mercury exposure. Environmental research, 110(3), 213-219.
Jardine, C. G. (2003). Development of a public participation and communication protocol
for establishing fish consumption advisories. Risk Analysis, 23(3), 461-471.
Kalkirtz, V., Martinez, M., & Teague, A. (2008). Environmental justice and fish
consumption advisories on the detroit river area of concern. School of Natural
Resources and Environment, University of Michigan, Ann Arbor, MI.
Knowles, M., Holton, E., & Swanson, R. A. (1998). The adult learner: The definitive
classic in adult education and human resource management. Houston, TX: Gulf
Publishing.
Kreuter, M. W., Lukwago, S. N., Bucholtz, D. C., Clark, E. M., & Sanders-Thompson, V.
(2003). Achieving cultural appropriateness in health promotion programs:
targeted and tailored approaches. Health Education & Behavior, 30(2), 133-146.
Kreuter, M. W., Oswald, D. L., Bull, F. C., & Clark, E. M. (2000). Are tailored health
education materials always more effective than non-tailored materials?. Health
education research, 15(3), 305-315.
Kreuter, M. W., & Skinner, C. S. (2000). Tailoring: What's in a name?.
O’Fallon, L. R., & Dearry, A. (2002). Community-based participatory research as a tool
to advance environmental health sciences. Environmental Health Perspectives,
110(Suppl 2), 155–159.
Pérez-Stable, E. J., Otero-Sabogal, R., Sabogal, F., & Nápoles-Springer, A. (1996).
Pathways to early cancer detection for Latinas: en accion contra el cancer. Health
Education Quarterly, 23(1_suppl), 41-59.
Perl, T. M., Bédard, L., Kosatsky, T., Hockin, J. C., Todd, E. C., & Remis, R. S. (1990).
An outbreak of toxic encephalopathy caused by eating mussels contaminated with
domoic acid. New England Journal of Medicine, 322(25), 1775-1780.
Matsumoto-Hervol, M., Duma, J., Johnson, M., Shand, E., & Gartner, B. (2013). Beneath
The Surface: Urban Fishing and Environmental Justice.
Minkler, M. (2000). Using participatory action research to build healthy
communities. Public health reports, 115(2-3), 191.
National Environmental Justice Advisory. (2002). Fish Consumption and Environmental
Justice. Environmental Protection Agency. WEB.

65

http://www.epa.gov/compliance/ej/resources/publications/nejac/fishconsumpreport_1102.pdf
Noar, S. M., Harrington, N. G., & Aldrich, R. S. (2009). The role of message tailoring in
the development of persuasive health communication messages. Annals of the
International Communication Association, 33(1), 73-133.
Rodríguez-Lázaro, D., Cook, N., Ruggeri, F. M., Sellwood, J., Nasser, A., Nascimento,
M. S. J., ... & Bosch, A. (2012). Virus hazards from food, water and other
contaminated environments. FEMS microbiology reviews, 36(4), 786-814
Skinner, C. S., Strecher, V. J., & Hospers, H. (1994). Physicians' recommendations for
mammography: do tailored messages make a difference?. American Journal of
Public Health, 84(1), 43-49.
Stellefson, M. L., Hanik, B. W., Chaney, B. H., & Chaney, D. J. (2008). Challenges for
tailored messaging in health education. American Journal of Health Education,
39(5), 303-313.
Todd, E. C. (1993). Domoic Acid and Amnesic Shellfish Poisoning-A Review. Journal
of Food Protection, 56(1), 69-83.
Toman, E., Shindler, B., & Brunson, M. (2006). Fire and fuel management
communication strategies: Citizen evaluations of agency outreach activities.
Society and Natural Resources, 19(4), 321-336.
Trainer, V. L., Cochlan, W. P., Erickson, A., Bill, B. D., Cox, F. H., Borchert, J. A., &
Lefebvre, K. A. (2007). Recent domoic acid closures of shellfish harvest areas in
Washington State inland waterways. Harmful Algae, 6(3), 449-459.
Teisl, M. F., Fromberg, E., Smith, A. E., Boyle, K. J., & Engelberth, H. M. (2011).
Awake at the switch: improving fish consumption advisories for at-risk women.
Science of the Total Environment, 409(18), 3257-3266.
Turner, G., & Shepherd, J. (1999). A method in search of a theory: peer education and
health promotion. Health education research, 14(2), 235-247.
Wekell, J. C., Trainer, V. L., Ayres, D., & Simons, D. (2002). A study of spatial
variability of domoic acid in razor clams: recommendations for resource
management on the Washington coast. Harmful Algae, 1(1), 35-43.
Wallerstein, N. B., & Duran, B. (2006). Using community-based participatory research to
address health disparities. Health promotion practice, 7(3), 312-323.
WDFW. (2017) Washington Razor Clam Management. Washington Department of Fish
and Wildlife. WEB.
http://wdfw.wa.gov/fishing/shellfish/razorclams/2017_razor_clam_season_setting
.pdf
WDOH. (2017) Beach Closure Signs. Washington Department of Health. WEB.
https://www.doh.wa.gov/CommunityandEnvironment/Shellfish/BeachClosures

66

WDOH. (2017) Shellfish Safety Information. Washington Department of Health. WEB.
https://fortress.wa.gov/doh/eh/maps/biotoxin/biotoxin.html

67