Risk and Health Communication Notes

Risk and Health Communication: Introduction

• Risk and health communication aims:
  • To inform about health risks.
  • To motivate the adoption of "recommended" or "healthy" behaviors.
• Effective health campaigns and interventions require understanding:
  • Factors that predict risk and health behavior.
  • How to influence these factors through communication.
  • How to overcome potential obstacles in persuading the audience.
• Course focus:
  • Theory and research on predicting and changing risk and health behavior.
  • The role of (social) media and technology in this context.
  • How to measure the effects of campaigns and interventions in practice.

Communicating About Risks

• Challenges:
  • Subjective nature of risk perception.
  • Balancing short-term vs. long-term effects; costs vs. gains.
• Importance of effective health communication:
  • Political leaders and health authorities need to:
    • Deliver clear messages.
    • Adapt their tone to be direct and specific.
    • Provide persuasive and educational materials.
    • Communicate in different languages.
    • Target various population segments.

Article Summary: Fighting COVID-19 with Effective Health Communication

1. Mass Information Flow:
   • Unprecedented flow of information in media.
   • Need for "concise, accurate, and valid info" to reach the public globally in different contexts.
   • Risk and Health Communication (RHC) addresses:
     • How to effectively deliver the message.
     • How to develop an effective health message.
     • How to reach different target groups.
2. Dealing with Insecurity and Fear:
   • Panic due to the contagious and deadly nature of COVID-19.
   • COVID-19 as an "invisible enemy" causing a feeling of loss of control.
   • RHC focuses on communicating risks in light of these insecurities.
3. Four Important Elements:
   • Open and honest communication about what is known and unknown, based on facts while acknowledging temporality.
   • Consistent and specific information using "Layman’s language" to avoid ambiguity.
   • Leadership providing decision-making skills, being reliable and honest, and acknowledging (visible) experts.
   • Acknowledging emotions by providing emphatic information, expressing concern, and recognizing the impact.
4. Promoting Behavioral Change:
   • Implementing behavioral measures at individual & community levels.
   • Converting routines into conscious actions.
   • Addressing the intention-behavior gap: "knowing" is not the same as "doing".
   • RHC aims to bridge this gap.
5. Four Recommendations:
   • Developing a "mental model": overview picture of how COVID-19 works.
   • Implementing interventions in the environment and through regulations/facilities.
   • Appealing to collective action: emphasizing "we are in this together" with leaders/role models on all levels.
   • Maintaining behavioral change by:
     • Changing self-regulation through conscious planning initially (action self-efficacy).
     • Preservation via habit (maintenance self-efficacy).

Risk and Health Defined

• Risk:
  • The likelihood that a specific event occurs.
  • The chance that something happens and its severity.
  • Risk perception is subjective and varies among individuals.
• Health:
  • WHO (1946): A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity (a "state").
  • Recently: the capacity of people to adapt to, respond to, or control life’s challenges and changes (a "dynamic process").
  • Objective health: determined by experts at the organic level.
  • Subjective health: determined by the individual, perceived health.
  • Social health: determined by the social environment, society.

Prevention Levels

• Prevention aims to avoid something from happening.
• The prevention level determines the marketing strategy and communication message.
• Three Levels:
  • Primary Prevention:
    • Preventing the development of illness.
    • Example: seatbelts, non-smoking signs, handwashing.
    • Maxim: "Prevention is better than cure."
  • Secondary Prevention:
    • Early detection of a disease/issue/problem.
    • Example: STD tests, dentist visits, COVID tests.
  • Tertiary Prevention:
    • Limiting the severity/consequences of a disease/issue/problem.
    • Example: obesity: promote adherence to treatment programs, exercise programs, counseling for coping strategies.

Social Marketing & Persuasive Communication

• Social marketing:
  • Marketing behavior by specifying the target group and connecting to behavior determinants and message factors.
  • Ex: "branding" behavior like smoking cessation.
  • Elements:
    • PRODUCT:
      • Actual product: the desired/recommended behavior.
      • Core product: profit from that behavior.
    • PRICE:
      • Literal price.
      • Figurative: loss (of the behavior) compared to the promised benefits.
    • PLACE:
      • Action outlets (where the intervention/behavior takes place).
    • PROMOTION:
      • Most visible part of social marketing.
      • Persuasive communication strategies.
      • Develop effective messages.
• Lifestyle diseases as a major cause of death. Why do people behave so risky/unhealthy?
  • Sometimes people don’t know, so it’s important to inform.
  • Often, people know but do it anyway. In this case, find out WHY.
  • Unrealistic optimism: knowing the facts and trying to ignore/downplay them.

Risk/Health Behavior: Prediction and Change

• Focus on beliefs influencing health-related variables.
• Socio-cognitive predictors of health behavior:
  • Focus on thoughts and feelings that determine health behavior.
  • Modifiable.
  • Key variables across many models.
• Why focus on thoughts and feelings?
  • Other predictors (socio-demographic, biological) are difficult to change.
  • Models are "tools" to identify crucial determinants for message strategy and campaign targets.
• Motivational Models:
  • Examples: TPB, PMT, EPPM, HBM.
  • Influence cognitive variables on intention formation.
  • Focus on the motivational phase of self-regulation: setting a goal, forming an intention.
• Behavioral Enhancement and Multi-Stage Models:
  • Examples: Implementation Intentions, TTM.
  • Focus on the volitional phase of self-regulation: planning & action directed toward achieving the set goal.

Theory of Planned Behavior (TPB - Ajzen, 1991)

• Behavioral Intention: Motivation/decision to perform a behavior.
  • Ex: Next month I plan to eat more healthy.
• Attitude: Evaluation of the behavior.
  • Ex: Eating more healthy next month is good/bad.
• Subjective Norm: Perceived social pressure related to the behavior.
  • Ex: Most people important to me expect me to eat healthy next month.
• Perceived Behavioral Control: Perception of ability to perform the behavior.
  • Ex: Weather I eat healthy next month is up to me.
• Attitude determinants:
  • Behavioral Beliefs (outcome expectancies): Beliefs about behavior consequences.
    • Ex: If I eat healthy, I will be able to wear my fav jeans.
  • Evaluation (outcome evaluation): How good/bad the outcome will be.
    • Ex: Being able to wear my fav jeans again, I think is…. good/bad?
• Subjective norm determinants:
  • Normative Beliefs: Beliefs about what important people expect you to do.
    • Ex: parents think I should eat healthy.
  • Motivation to Comply: How important to do what others want you to do.
    • Ex: With regard to healthy eating, I think it is important to behave like my parents expect me to behave
• Perceived behavioral control determinants
  • Control beliefs: Reflecting upon your experience with the behavior and facilitators/inhibitors that influence behavior
    • Ex: I think I will be strong enough to resist unhealthy foods and eat more healthy the next month
  • Power of control beliefs: The extent that behaving helps me to eat more healthy the next month
    • Ex: Being strong helps me to eat more healthy the next month

(TPB) Principle of Aggregation

• Use multiple items to measure a construct. Too complex for one item, and must see individual variation.
• A construct can have multiple aspects, needing multiple items.
  • Ex: Subjective norm - significant others can be various persons (friends/family).
• Advantage of using multiple items:
  • More valid&relaible measurement
  • You are able to see more individual variation
  • You can check consistency of participant answers

(TPB) Principle of Compatibility

• Health behaviors involve multiple dimensions:
  • Actions: buying / using / having.
  • Target: a condom / a STD test / a HIV test.
  • Context: in a pharmacy / clinic / GP (huisarts) / at home.
  • Time: tomorrow / next week / month / year.
• Be as specific as possible and make all items compatible (same action/topic/context/time).
• TPB variables correlate stronger with behavior when more compatible.
• Example:
  • Behavior: doing a HIV test in the clinic next week.
  • Then also attitude, subjective norm, PBC about this specific behavior (doing a HIV test in the clinic next week).

PROTECTION MOTIVATION THEORY (PMT - Rogers, 9175, 1983)

• PMT - variables
  • Threat appraisal (how threatening is this?)
    • Severity: how severe are the consequences of this health risk?
    • Vulnerability: do I feel personally vulnerable to this health risk?
  • Coping appraisal (how to deal with this threat?)
    • Response efficacy: is the recommended behavior effective in reducing the health risk?
    • Self-efficacy: can I perform the recommended behavior?
      • cf. PBC (perceived beh control) in the TPB (theory of planned beh)

Measuring Variables from PMT:

• Perceived severity:
  • How severe do you consider the consequences of drinking alcohol? (not at all severe - very severe).
  • How damaging do you think it is for your body to drink alcohol? (not at all damaging - very damaging).
• Perceived vulnerability:
  • It is likely that I will develop health complaints because of my alcohol consumption (disagree - agree).
  • Because of my alcohol consumption I have an increased risk at liver problems (disagree - agree).
• Response-efficacy:
  • Drinking less alcohol reduces my risk at liver problems (disagree - agree).
  • Drinking less alcohol is a good way to reduce your chance at liver failure (disagree - agree).
• Self-efficacy:
  • I am able to drink less alcohol (disagree - agree).
  • It is difficult for me to drink less alcohol (disagree - agree).
• Remaining variables:
  • Rewards: positive aspects of maladaptive behavior
    • Drinking alcohol is cool
  • Response costs: disadvantages of the healthy behavior.
    • I am shy and less talkative, if I drink less (cf. beliefs in TPB)

Other Socio-Cognitive Models

• HEALTH BELIEF MODEL (Conner, 2010)
• SOCIAL COGNITIVE THEORY (Conner, 2010)
• TRANSTHEORETICAL MODEL OF CHANGE (TTM - Conner, 2010)
• Stage model of health behavior
  • Different stages - different cognitions important
    1. Pre-contemplation: Smoker unaware of the problem, no intention to stop
    2. Contemplation: Smoker starts to think about behavior change
    3. Preparation: Quit intention, planning to stop smoking
    4. Action: Quitting smoking
    5. Maintenance: Prevent relapse, consolidate non-smoking status

Shortcomings of Socio-Cognitive Models (Conner, 2010)

• Stability predictors (t1) - behavior (t2)
  • Assumption: measured cognitions (e.g., intentions) remain stable
  • Incorrect: cognitions can change after you measured them
  • Problem: less predictive of behavior
  • If cognitions are more stable, stronger relations with outcomes (‘intention stability’)
• Too little attention for emotions
  • TPB + anticipated regret/guilt - explains more variance in intentions
    • If I binge drink tonight, I will regret it
    • If I binge drink tonight, I will feel guilty
• Focus on motivational phase
  • Models end with intention formation
  • Implementation intentions (see lecture on this topic)

Integrative Model of Behavioral Prediction (IMBP, Conner, 2010; Fishbein&Yzer, 2003; Robbins&Niederdeppe, 2015)

• Fishbein&Ajzen (1975, 2010): "… although an infinite number of variables may in some way influence behavior, only a small number of variables need to be considered to predict, change, or reinforce a particular behavior in a particular population"

Applying Models to Health Communication

1. Define behavior
   • What behavior do you want to change?
   • More specific = better
     • Ex: 3x per week 20 min exercise vs. exercise vs. lose weight
   • Define the 4 elements: action, target, context, time → Principle of Compatibility
     • "… a behavior can be defined as an action directed at a target, performed in a certain context at a certain point in time"
2. Identify intervention goal and target population
   • Why does the target population not perform the recommended behavior?
   • Intention-behavior configuration (what to focus on here?)
3. Elicit relevant beliefs (i.e., find out what beliefs target group has)
   • What beliefs does the target population has about the behavior?
   • Qualitative research, open questions, please describe…..
     • Advantages/disadvantages of the behavior (outcome beliefs)
     • Describe the people that would approve/disapprove the behavior (normative beliefs)
     • List factors that make it easy/difficult to perform the behavior (self-efficacy beliefs)
4. Select beliefs that should be targeted by the message
   • Which beliefs differ between people that perform vs. not perform the behavior?
   • What beliefs are important predictors of intentions/behavior?
   • Hornik & Woolf (1999)
     • Belief must be strongly related to intention/behavior you want to change
     • There should be enough people that do not already hold the targeted belief
     • Is it in fact possible to change the belief?

Changing VS Priming Beliefs

• How to apply to develop health communication? → Robbins & Niederdeppe (2015) → slides 33-47 (IMBP)
• The idea that health communication should focus on changing beliefs and related variables is one approach to try to change health behaviors.
• Fisbein and Yzer (2003, from pp. 175) also suggest an alternative approach called “Media Priming”.
• The media priming approach suggests that you do not need to change beliefs, but by communicating a belief (that is in line with the desirable behavior), this belief can become more cognitively accessible and therefore influence behavior more.
• Put differently, the health communication then does not change the belief but makes the association (correlation) between that belief and the desirable behavior stronger.

Recap: Socio-cognitive models

• Focus on modifiable variables (thoughts and feelings)
• Models are a ‘tool’ to identify the crucial determinants of health behavior
  • To select a message strategy → what to target in a health campaign?
• Different target group, different behavior (action/topic/context/time)?
  • You need a new study to investigate the relevant beliefs!
• Models only say what determinant you should target (message strategy), not how you can target this determinant (message design - use of message factors)

Implementation Intentions (imps)

• Intentions: I intend to do X
  • X = behavior (exercise) or goal (reduce weight with 5 kilos)
  • Creates commitment to the behavioral/goal
• FROM INTENTIONS TO BEHAVIOR
  • Are intentions good predictors of behavior?
    • Sheeran (2002): meta-analysis of meta-analyses
      • Intentions explain 28% of variance in behavior
      • Big effect (but correlational)
    • Webb & Sheeran (2006): meta-analysis experimental studies
      • Does change in intentions predict behavior change?
      • Medium-large change in intentions → small-medium change behavior
    • Sheeran (2002): health behavior
      • ~50% of the people with a positive intention to perform healthy behavior, does not perform this healthy behavior
      • Intention-behavior gap
      • Oscar Wilde: “Good resolutions are useless attempts to interfere with scientific laws. Their origin in pure vanity. Their results is absolutely nil”
      • The road to hell is paved with good intentions

Explaining the intentions-behavior gap

• Intention viability
  • Intentions can only be realized when you have control over the behavior
  • Abilities, resources, opportunities
• Intention activation
  • Environment/context can also activate different goals (intentions)
  • Temptations: short vs. long-term goals
  • People ‘forget’ or re-prioritize their goals
• Intention elaboration
  • Intentions can only be realized when you think through all actions needed to reach your goals
  • Health behavior = complex
• Ex: condom use
  • Buy, store, carry condom
  • Suggest using it to partner
  • Think about what to do when partner doesn’t want to use it
  • → Health behavior = complex
  • → Healthy intentions don’t always translate into healthy behavior
• Strong effects of simple plans (Gollwitzer, 1999)

How can we reduce the gap between intentions and behavior?

• Use implementation intentions (imps)!
• Based on idea that motivation is important, but not sufficient
  • Motivational models stop at intention formation (motivational phase of self-regulation)
  • Imps focus on volitional phase of planning and action to reach goals (intentions)
  • Imps are also called "if-then plans"
  • See Gollwitzer & Oettingen (2013) for a general review
• "Normal" intentions: I intend to do X
  • X = behavior (exercise) or goal (reduce weight with 5 kilos)
  • What you want to do
  • Creates commitment to the behavior/goal
• Implementation intentions: When situation Y happens, I do Z!
  • Y = situational cue relevant for the goal (good opportunity to act, obstacle)
  • Z = instrumental goal-directed response
  • When, where and how you will do something
  • Creating association between metal representation situation and goal-directed response (if-then plans)
• I intend to drink less alcohol
• If the waiter asks what I would like to drink, I will order a mineral water!
• Forming imps
  • Mental act whereby you link the anticipated opportunity to act to a goal-directed response
  • A conscious act that creates an association

Why do imps work? - idea

• Thinking about a good opportunity to act beforehand, makes this situation cognitively more accessible
  • Because it is more accessible you will recognize the good opportunity to act faster!
  • And this increases the likelihood you will use this opportunity to act!
• Thinking about how to respond beforehand, makes it more likely you automatize this reaction
  • If I encounter situation Y, I will do Z!
• “Passing control of one’s behavior on to the environment”
  • When I get home from work, I go for a run. I get home from work, so I go running
    • This is different from deciding at that particular moment…more difficult because of temptations (watching Netflix)
    • Imps create strong cue-response link (getting home-running)

Do imps work? - proof (slide 14)

• Efficacy imps demonstrated for student and non-student samples, self-report and objective behavioral measures, and for various behaviors
• Efficiacy imps demonstrated with regard to different self-regulation problems
  • Getting started - starting to pursue a goal
    • Imps (vs control) condition: more often get a flu shot, take pills, participate in population screening…
  • Staying on track - keep pursuing a goal
    • “If I open the fringe, I will think of dieting”
    • Imps (vs control) condition: dieters lost more weight → you are more likely to be successful in intentions if you decide when and where you will fulfill the action.

Why do imps work? - proof

• Forming imps (or if-then plans) facilitate
  • Recognizing a good opportunity to act
    • If-component plan
    • Activated mental representation relevant situational cues, so cognitively more accessible (cue accessibility)
    • Person is “perceptually ready”
  • Automatic execution of goal-directed response
    • Then-component plan
    • Creates strong cue-response link, automatizes reaction
  • Contrary to “normal” intentions where you first still have to recognize the good opportunity, think what you can do best… and then also do it!

Webb & Sheeran (2007)

• Aim: to test if cue accessibility and the strong cue-response link together mediate the effect of imps on goal achievement
• Participants make word search puzzle
• Task: identify if puzzle contains word or non-word learned prior to doing this task (DV = RT key press when puzzle contains learned word)
• Imps condition: to respond quickly to learned word
• Control condition: familiarize yourself with word
• Computer task to measure underlying processes
• Remember a list of
  • 4 existing words (mosaic, biscuit, circus, netball)
  • 4 non-words (avenda, grarpes, weemed, frounge)
    • Will appear in word search puzzles
• Formation tips
  • Imps condition
    • If i see avenda, then i will press the key especially quickly!
  • Control condition
    • Try to respond quickly to avenda by faliliarizing yourself with this word
  • Repeat this instruction in silence (30 sec)
• Measuring underlying processes
  • Primed lexical decision task
    Decide as fast as possible if this is a word or a non-word by pressing the correct key
• Trial
  • Fixation dot (1500ms)
  • Prime word (17ms)
  • Random string letter (225ms)
  • Target word (until reaction)
• Results: slides 20-28

Study summary

• If-then plans facilitates translating ”normal” intentions into actual behavior
  • Reduces intention-behavior gap!
• Effectiveness demonstrated for various behaviors, samples etc
  • Exercise, eating, cancer screening, taking medicines, smoking, alcohol consumption
• Underlying processes
  • Increased cue-accessibility (‘perceptual readiness’)
  • Stronger cue-response link

Implementation intentions - implications for interventions

• Interventions (communication campaigns) often based on motivational models (IMBP/PMT)
  • Focus on intention formation
• Implementation intentions
  • Focus on post-intentional or volitional phase, developing strategies, plans to translate intentions into behavior
• Implication: intervention that combines both most effective?
• Milne et al. (2002)
  • Combine motivational intervention based on PMT + implementation intentions (imps)
  • Behavior: exercise
  • Hypotheses
    • PMT intervention (health info) influences PMT-cognitions (vulnerability, severity, fear, self and response efficacy) + greater intentions
    • But….imps needed to translate intentions into actual behavior!

CONCLUSION

• Motivational vs. volitional phase of self-regulation
• Imps help to translate intentions into actual behavior
  • Reduces intention-behavior gap!
• Underlying mechanisms
  • Cue accessibility
  • Stronger cue-response link
• Implications for health campaigns and intervention

Risk Perceptions

• Why is it so difficult to interpret numbers correctly?
  • Heuristics and biases
  • Displaying and communicating health risks → unrealistic optimism
• Calman et al. (1999)
  • “Doing an effective job of risk communication often means finding comprehensible ways of presenting complex material that is clouded by uncertainty and is inherently difficult to understand”
• Vaccinate or not?
  • “The vaccine works for two types of the HPV virus that together are responsible for causing 70% of cervical cancers. The vaccine does not offer full protection. When you are vaccinated, however, You have a much smaller chance of getting this type of cancer.”
    Risk perceptions and interpretations → Heuristics and biases
• RISK

Risk Defined

• The likelihood of an adverse event occurring (within a specific time)
• Elements:
  1. Likelihood: how likely is it?
  2. Severity: how severe is it? How acceptable?
  3. Timing: direct, in a few weeks, 10 years…?
• $Probability = 1 - RISK$
• Subjective perception of risks
• Often very different from the objective probability that something will happen
• Whether a risk is acceptable depends on the perceived benefits of a certain activity (e.g., using a tanning bed) Heuristics and biases

Heuristics and biases

• Tversky & Kahneman (1974)
  • People often use heuristics: mental shortcuts, rules of thumbs
  • Availability heuristic
    • Perceived likelihood is determined by how easy or difficult it is to bring particular instances to mind
    • What is cognitively accessible to you influences perceived likelihood
    • Consequence
      • Risks that are highly accessible are overestimated
        • Role of media (priming, agenda setting)
        • Lichtenstein et al. (1978): “Causes of death that attract more publicity (e.g., murder) are judged more likely to occur than those that attract less publicity (e.g., suicide or certain types of cancer), contrary to the true state of affairs”
  • Representativeness heuristic Events that are representative or typical of a class are assigned a high probability of occurrence
    • Coin tosses: which sequence is most likely to occur?
    • H=head; T=tails
      • HTHHTH
      • HHHTTT
      • HTHHHH
    • A panel of psychologists have interviewed and administered personality tests to 30 engineers and 70 lawyers, all successful in their respective fields.
      This info was used to produce descriptions of engineers and lawyers. Below you find one such description (randomly selected). Read the description and decide if Jack is an engineer or a lawyer.
    • “Jack is a 45-year-old man. He is married and has four children. He is generally conservative, careful and ambitious. He shows no interest in political and social issues and spends most of his free time on his many hobbies, which include home carpentry, sailing and mathematical puzzles.”
    • Participants were told that description came from sample of
      • 30 engineers and 70 lawyers
      • 70 engineers and 30 lawyers
    • Is Jack an engineer or a lawyer?
      • Participants: 90% chance that Jack is engineer, regardless of info about the sample!
      • Chance that Jack is engineer is biggest in 2nd sample
      • We ignore this info and only use the stereotypical description of the engineer and conclude Jack is engineer
    • Consequences
      • We ignore ‘baseline’ information
        • When description comes from population with 30 engineers and 70 lawyers → lawyer bigger chance
      • We show misconceptions of chance
        • Ex: the ‘gambler’s fallacy’
        • We view chance as a self-correcting process (even in the short-term)
        • 10 x roulette…..10 x red!
        • Next spin: most people think probability landing on black is greater than landing on red….
        • 11th roulette: equal chance of landing of black or red!
  • Anchoring heuristic
    • Judgements are influenced by a particular ‘anchor’ that is given
    • People make adjustments from this starting value when assessing probabilities
    • Ex: Estimates of the number of murders per year are dependent on other examples given
      • 1,000 deaths by electrocution
      • 50,000 deaths by motor accidents

Displaying risks: percentages

• Percentages are difficult to understand
  • What does a 50% chance mean?
• Often people interpret a risk of 50% literally
  • Julie who has 3 sisters: “The chance that we get the disease is 50%. This means that two of us will get it and two of us will not get it. My sister already has the disease, so one of us will still get it.” (McAllister, 2003, Clinical Genetics, 64, 179-189)
  • Chance does not have a memory…

Displaying risks: frequencies

• Frequencies are easier to understand!
• Compare these two scenarios
  • The probability that a 40-year-old woman has breast cancer is about 1%. If she has breast cancer, the probability that she tests positive on a screening is 90%. If she does not have breast cancer, the probability that she nevertheless tests positive is 9%. What are the chances that a woman who tests positive has breast cancer?
  • Think of 100 women. One has breast cancer, and she will probably test positive. Of the 99 who do not have breast cancer, 9 will also test positive. Thus, a total of 10 women will test positive. How many of those who test positive have breast cancer?
• With percentages people easily ignore the baseline information (scenarios: how many people are there in each group)
• Many experiments show that risk estimates become more accurate when using frequencies (instead of %) in the risk information
• Gigerenzer (2002)
  • Everybody has problems with % (general public, students, professionals)
  • Frequencies are easier because of
    • Computational simplicity
    • Fit with how we encountered info about risks during evolution (evolutionary explanation)

Displaying risks: pictures

• Display risks in a picture instead of using numbers only
  • $1/10$
  • 10%
• Displaying risks: verbal labels
• Examples:
  • extremely rare, sometimes, often, quite high, very likely
• Advantages
  • Easy to understand
  • Takes uncertainty into account
  • Do not imply precision
• Disadvantages
  • Imprecise, inexact, vague
  • Huge variance in terms of how labels are interpreted

Displaying risks: form of presentation

• Absolute risk presentation

  • Your risk at disease X is reduced with 5%: from 10% to 5%

• Relative risk presentation

  • Your risk at disease X is reduced with 50%

• Cumulative risk presentation

  • Little risks, together, can result in a substantial cumulative risk when viewed over a longer time course
    • 1 candy bar poses little risk at becoming overweight; 1 candy bar per day poses much bigger risk at becoming overweight

• Natter & Berry (2005): baseline info [Slides 21-26]

  • RQ: What is the effect of baseline info on the interpretation of relative and absolute risk information?
    Baseline info: baseline/initial level of risk Results:
  • With baseline info more accurate risk estimates!
  • Satisfaction with info
    • With baseline higher satisfaction, for both absolute and relative risk info
  • Perceived effectiveness of vaccination
    • Overall, with baseline info higher perceptions of effectiveness
    • Without baseline info, higher for relative risk info
  • Intention to get flu shot
    • Overall, with baseline info stronger intention
    • Without baseline info, higher for relative risk info Conclusion
      • Without baseline info about risk level
        • Relative risk communication more persuasive (perceived effectiveness & intentions)
      • No difference absolute –relative info when baseline info is included
      • And baseline info about risk level causes
        • More accurate risk estimates
        • Higher satisfaction, perceived effectiveness and intentions
      • Including baseline info about risk level is important!

• When communicating about risks be aware of the influence of:

  • Heuristics and biases
  • Presentation format

Risk perceptions

• Unrealistic optimism
  • [Ted talk - the optimism bias]
  • When you think that it is less likely that something bad will happen to you, while this is, or this cannot be true
  • When you think that it is more likely that something good will happen to you, while this is, or this cannot be true
  • Unrealistic optimism ≠ dispositional optimism
    • Dispositional optimism is a personality trait representing generally positive expectations about the future

Shepperd et al