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PubMed2005

The role of HIV-related knowledge and ethnicity in determining HIV risk perception and willingness to undergo HIV testing among rural women in Burkina Faso.

We conducted a random community based survey of 300 young (15-29 years) rural women in Nouna, Burkina Faso. Only one-third of women were aware that a person could have HIV without having symptoms and these women were significantly more likely to classify themselves to be at high risk for getting HIV. Furthermore, multiple partners, Bwaba ethnicity and having mentioned a health worker as a source of HIV information were significantly associated with perceived high personal risk. Perceived willingness to participate in VCT was high (69%). The dissemination of information on the asymptomatic nature of HIV infection could potentially be very important in forming risk perception, awareness, and their willingness to participate in HIV interventions.

AIDS Serodiagnosis↗

PubMed2002

Information disclosure and smoking risk perceptions. Potential short-term impact on Spanish students of the new European Union directive on tobacco products.

BACKGROUND: The Directive 1999/0244 (COD), recently approved by the European Parliament, proposed that the content and presentation of health warnings on cigarette packets be modified. The aim of the present study was to analyse the potential effect of the planned measures on the perceptions by Spanish youth of the risks associated with smoking. METHOD: A sample of 435 students attending the University of La Rioja were surveyed on their perceptions of the principal health risks attributable to the consumption of tobacco i.e. lung cancer, respiratory diseases and cardiovascular disease. A questionnaire was administered before and after they were presented with a demonstration of the health warnings on cigarette packets based on the new European Union directive. RESULTS: Perceptions changed significantly following exposure to the content and type of information of the new packaging. In general, the university students attributed a higher health risk to smoking following the presentation. CONCLUSIONS: The measures developed by the public sector to present a higher profile of anti-tobacco health warnings do influence the target population in the desired direction, at least in the short term. Hence, given that the perception of risk influences the election to smoke, it is predictable that when these types of policy decisions are applied, there will be a tendency towards a reduction in the incidence and prevalence of tobacco consumption.

Adolescent↗

PubMed2025

Impact of personalised risk predictions on breast cancer risk perceptions: insights from the BREATHE study.

OBJECTIVE: Biennial mammography screening is well-established for women aged 50 and above, but guidelines for younger women are less clear. Risk-based screening may provide women with key information to make informed decisions about their breast cancer risk and screening. This study examines how predicted breast cancer (BC) risk shapes women's perception and confidence in risk prediction. METHODS: Women aged 35 to 59 years were recruited for a prospective multi-centre cohort and stratified into above-average, average, or below-average BC risk categories based on genetic and non-genetic risk factors. Perceived risk was assessed at enrolment and after participants were informed of their predicted risk. We used ordinal models to identify predictors of perceived risk and logistic regression to examine the relationship between changes in perceived risk and confidence in the risk prediction. RESULTS: At enrolment, 43% and 47% of 4112 participants perceived their BC risk pre-result as low or average, respectively. Thirty-five percent adjusted their perceived risk to align more closely with their predicted risk. Predictors of perceived risk post-result: perceived risk pre-result, predicted risk, ethnicity and having regular menstruation. Participants who underestimated their BC risk were nearly eight times more likely to have low confidence in the accuracy of their predicted risk (OR for underestimation vs. accurate perception: 7.94 [95% CI 5.60-11.28]). Predictors of perceived risk post-result: perceived risk pre-result, predicted risk, ethnicity and having regular menstruation. Confidence in risk prediction was lowest when women's perceived risk pre-result was lower than their predicted risk (OR-2 vs 0 [95%CI] 5.06 [3.67 to 6.97]). CONCLUSION: Many women underestimated their BC risk, and their initial perceptions were influenced by the knowledge of their predicted risk. Women who underestimated their risk had less confidence in their predicted risk scores.

Humans↗

PubMedDate not supplied

Sexual risk and perception of risk for HIV infection among multiethnic family-planning clients.

Little is known about the relationship among having risks for human immunodeficiency virus (HIV) infection, perceiving oneself at risk, and initiating risk reduction for young sexually active women. We surveyed a multiethnic sample of 267 young-adult female family planning clients attending Planned Parenthood clinics to determine these relationships. Perceiving oneself at risk was significantly associated with having sex outside of a primary relationship in the past year, with having five or more sexual partners in the last five years, and with having a primary partner who has other partners. We found no significant relationship between perceiving oneself at risk and adopting risk-reduction strategies, such as inquiring about a partner's risks or using condoms. These data suggest that the women in this population may be overly optimistic about their invulnerability to HIV. While those women who perceived themselves to be at risk for becoming sexually infected with HIV were more likely to report high-risk behaviors, perception of risk did not motivate these women to adopt low-risk behavior. These data suggest that simple HIV education and acknowledgement may have little effect on reducing exposure to HIV among the women in this population. Alternative strategies for reducing risk must be explored.

Adult↗

PubMed2005

Coronary heart disease in ethnically diverse women: risk perception and communication.

OBJECTIVES: To assess perceived vs calculated risk of coronary heart disease (CHD), preferred methods of communicating risk, and the effect of brief educational intervention to improve accurate perceptions of personal risk. SUBJECTS AND METHODS: Of 1858 women who underwent screening mammography between April and September 2003 at the Columbia University Medical Center in New York, NY, we assessed 125 women with no history of cardiovascular disease who participated in a risk factor screening and education program. Demographic variables were evaluated by interviewer-assisted standardized questionnaires. Absolute 10-year CHD risk was calculated using the Framingham global risk assessment. Perceived 10-year risk and preferred method of communicating risk were evaluated systematically. RESULTS: Among 110 research participants who were eligible for risk estimation, 59% had a 10-year risk of less than 10%. However, only half of those women accurately perceived their risk as low. After a brief educational intervention, the women's ability to correctly categorize their personal CHD risk improved significantly. Preferred methods to communicate risk varied by level of education and age. Older women (> or = 65 years) and those with a high school education or less were more likely to prefer simple methods of having CHD risk communicated compared with their counterparts. CONCLUSIONS: These data underscore the need to determine preferences for providing risk information and to test various formats for communicating CHD risk to improve awareness and management of CHD risk factors, especially among women of different age groups and education levels.

Adult↗

PubMed2002

Fishing along the Clinch River arm of Watts Bar reservoir adjacent to the Oak Ridge Reservation, Tennessee: behavior, knowledge and risk perception.

Catching and eating fish is usually viewed as a fun, healthy and safe activity. However, with continuing increases in fish consumption advisories due to the contamination of our environment, anglers have to decide whether or not to eat the fish they catch. The Clinch River arm of Watts Bar Reservoir is under a fish consumption advisory because of elevated PCB concentrations in striped bass (Morone saxatilis), catfish (Ictalurus spp.) and sauger (Stizostedion canadense) due in part from contaminants released from the US Department of Energy's (USDOE's) Oak Ridge Reservation (ORR) in East Tennessee. To obtain information about the demographics, fishing behavior, knowledge, fish consumption and risk perception of anglers, a survey was conducted of 202 people actively fishing either on land or by boat along the Clinch River arm of Watts Bar Reservoir adjacent to the ORR from Melton Hill Dam to the Poplar Creek confluence or on Poplar Creek within ORR boundaries from mid-March to early November 2001. Even though 81% of people interviewed knew about the fish consumption advisories for the study area, 48% of them thought the fish were safe to eat, while 38% ate the fish that they caught from the study area. Approximately 36% of anglers who had knowledge of the fish consumption warnings ate fish from the study area. Providing confirmation that people fish for many reasons, 35% of anglers interviewed did not eat fish at all. The majority of anglers interviewed knew about the fish consumption advisories because of the signs posted throughout the study area. However, few people knew the correct fish advisories. Significantly fewer blacks had knowledge of the fish consumption warnings than whites. Information resulting from this study could be used to design a program with the objective of reaching the people who may be most at risk from eating fish caught from the Clinch River arm of Watts Bar Reservoir.

Adult↗

PubMed2001

The multimedia computer for low-literacy patient education: a pilot project of cancer risk perceptions.

OBJECTIVE: Inadequate reading literacy is a major barrier to better educating patients. Despite its high prevalence, practical solutions for detecting and overcoming low literacy in a busy clinical setting remain elusive. In exploring the potential role for the multimedia computer in improving office-based patient education, we compared the accuracy of information captured from audio-computer interviewing of patients with that obtained from subsequent verbal questioning. SETTING: Adult medicine clinic, urban community health center PATIENTS: Convenience sample of patients awaiting clinic appointments (n = 59). Exclusion criteria included obvious psychoneurologic impairment or primary language other than English. INTERVENTION: A multimedia computer presentation that used audio-computer interviewing with localized imagery and voices to elicit responses to 4 questions on prior computer use and cancer risk perceptions. MEASUREMENTS AND MAIN RESULTS: Three patients refused or were unable to interact with the computer at all, and 3 patients required restarting the presentation from the beginning but ultimately completed the computerized survey. Of the 51 evaluable patients (72.5% African-American, 66.7% female, mean age 47.5 [+/- 18.1]), the mean time in the computer presentation was significantly longer with older age and with no prior computer use but did not differ by gender or race. Despite a high proportion of no prior computer use (60.8%), there was a high rate of agreement (88.7% overall) between audio-computer interviewing and subsequent verbal questioning. CONCLUSIONS: Audio-computer interviewing is feasible in this urban community health center. The computer offers a partial solution for overcoming literacy barriers inherent in written patient education materials and provides an efficient means of data collection that can be used to better target patients' educational needs.

Adult↗

PubMed2004

GM foods and the misperception of risk perception.

Public opposition to genetically modified (GM) food and crops is widely interpreted as the result of the public's misperception of the risks. With scientific assessment pointing to no unique risks from GM crops and foods, a strategy of accurate risk communication from trusted sources has been advocated. This is based on the assumption that the benefits of GM crops and foods are self-evident. Informed by the interpretation of some qualitative interviews with lay people, we use data from the Eurobarometer survey on biotechnology to explore the hypothesis that it is not so much the perception of risks as the absence of benefits that is the basis of the widespread rejection of GM foods and crops by the European public. Some respondents perceive both risks and benefits, and may be trading off these attributes along the lines of a rational choice model. However, for others, one attribute-benefit-appears to dominate their judgments: the lexicographic heuristic. For these respondents, their perception of risk is of limited importance in the formation of attitudes toward GM food and crops. The implication is that the absence of perceived benefits from GM foods and crops calls into question the relevance of risk communication strategies for bringing about change in public opinion.

Biotechnology↗

PubMed2001

Physician intervention and patient risk perception among smokers with acute respiratory illness in the emergency department.

BACKGROUND: Acute Respiratory Illness accounts for over 12 million visits to emergency departments in the United States each year. Between one-fourth and one-half of these patients are smokers. We examined the frequency of physician intervention for smoking cessation among acute respiratory illness patients in the emergency department, and examined the influence of physician intervention on patients' perceived risk from smoking and motivation to quit. METHODS: This study was conducted in the emergency department of a large inner-city hospital. Adult smokers (n = 63) presenting with symptoms of acute respiratory illness were surveyed by exit interview while in the emergency department. The frequency and extent of physician interventions for smoking were examined using the Agency for Health Care Policy and Research guidelines as a model. We also assessed patients' perceptions of risk from smoking, the presence of other household smokers, and the patients' motivation to quit. RESULTS: Emergency department physicians provided incomplete and inconsistent intervention for smoking. While most patients reported being asked if they smoked, only half of smokers were advised to quit. Only 9% were offered any assistance with quitting. Risk perception was generally low, however, the majority of smokers were willing to receive on-site smoking cessation counseling while in the emergency department. CONCLUSIONS: The small sample size in this study requires that results be interpreted with caution. However, the findings of this study suggest that the emergency department setting may provide a unique "teachable moment" in which to initiate smoking cessation counseling for this high-risk population.

Adolescent↗

PubMed2005

Sexual victimization in relation to perceptions of risk: mediation, generalization, and temporal stability.

There is evidence that personal experience with trauma is associated with increases in both personal and comparative risk perception. This study investigates this relation in terms of sexual victimization among women, focusing on three potential mediators: perceived control over sexual assault, perceived similarity to a typical sexual assault victim, and psychological distress. Mediational analyses were investigated using structural equation modeling. Although victimization experience was not related to comparative risk perception, it was associated with greater personal risk perception. This relation was mediated by perceived similarity to a typical sexual assault victim. Prospective analyses indicated that personal risk perception does change in response to sexual victimization but also indicated that heightened risk perception may be an accurate assessment of risk that actually precedes victimization experience. Implications for the meaning of perceived similarity and perceptions of risk for sexual assault victims are discussed.

Adolescent↗

PubMed2005

The role of odor and irritation, as well as risk perception, in the setting of occupational exposure limits.

OBJECTIVE: This paper reviews current research regarding the relationship between odor perception or irritation and setting an occupational exposure limit (OEL). Special focus was directed at those settings where a small fraction of persons report unacceptable responses to concentrations well below the OEL. METHODS: We evaluated the published literature on the topic of irritation and olfactory response to exposure to industrial chemicals. More than a dozen researchers have been active in this area over the past 10 years. RESULTS: It was found that for some chemicals, even when one maintains airborne concentrations below a particular OEL, this level of exposure may not be adequate to prevent all persons from reporting an appreciable adverse response. In some cases, worker's pre-existing belief systems about the source of an odor may be sufficient to require that they have not be exposed to any detectable concentration. In addition, detection of odors by workers may tap into the person's aversion to odors, in general. In both situations, it is often necessary to address these specific issues through risk communication and dealing directly with risk perception. CONCLUSIONS: For practical reasons, the current objective of organizations charged with setting OELs for chemicals is to identify concentrations that do not cause irritation or widespread reports of unpleasant sensory stimulation in the vast majority of workers (e.g., about 80-95%).

Air Pollutants, Occupational↗

PubMed2002

Breast cancer risk perception among women who have undergone prophylactic bilateral mastectomy.

BACKGROUND: Prophylactic bilateral mastectomy is a preventive option for women who are at high risk of developing breast cancer. We compared the perceptions of breast cancer risk among women who had previously undergone prophylactic bilateral mastectomy with objective estimates of their breast cancer risk. METHODS: We asked 75 women in the Canadian province of Ontario who had undergone prophylactic bilateral mastectomy between 1991 and 2000 to provide a complete family history of the cancers that had occurred by the time of their surgery and to indicate their BRCA1 and BRCA2 gene mutation status. This information was used to generate estimates of each woman's risk for breast cancer by using the Gail model, the Claus model, and the BRCAPRO model. Sixty of the women also provided their own estimates of their lifetime risks of developing breast cancer before and after they had prophylactic mastectomy. Risk estimates were compared using Wilcoxon's signed-rank test and Pearson's product-moment correlation analysis. All statistical tests were two-sided. RESULTS: The women estimated that their lifetime risk of developing breast cancer before surgery was, on average, 76% (range = 20%-100%) and after surgery was 11.4% (range = 0%-60%). The mean estimated absolute risk reduction the women attributed to prophylactic mastectomy was 64.8%. The average computer-generated risk estimates were 59% for the 14 women who reported that they carried a BRCA1 or BRCA2 gene mutation and 17% for the other women (of whom 43 had a strong family history of breast cancer and 18 had a limited family history). Breast cancer risk was statistically significantly overestimated by all women except for the known BRCA1 and BRCA2 gene mutation carriers. CONCLUSION: Women who undergo prophylactic bilateral mastectomy have an exaggerated perception of their breast cancer risk before surgery. Formal genetic counseling and genetic testing may result in more accurate risk perceptions to guide women in choosing other preventive options.

Breast Neoplasms↗

PubMed2006

[SAR values of mobile phones. Safety evaluation and risk perception].

The specific absorption rate (SAR) is a prominent topic in the discussion about precautionary health protection. An experimental study investigated the effect of information about various SAR values (below the existing partial body limit value of 2 W/kg) on safety judgments of potential mobile phones users. It turns out that about 94% of the participants do not know the SAR value of their own mobile phone. SAR values below existing limits are not perceived as equally safe. Rather, the lower the SAR value, the higher the perceived safety. However, a majority of the participants does not consider these SAR values to be 100% safe, even if they are clearly below the existing limits. Explicitly indicating a precautionary limit value (referring to the Federal Office for Radiation Protection or to consumer organizations) does not change this safety evaluation. As expected, safety evaluation of the SAR values is also related to the perception of mobile phone risks. Those who are concerned about mobile phone communication give lower safety judgments than the unconcerned-independent of the level of the SAR values. Irrespective of that, our results suggest that establishing the SAR value as a criterion for mobile phones depends first of all on making it known to the public.

Adult↗

PubMed2004

Effects of alcohol and expectancies on HIV-related risk perception and behavioral skills in heterosexual women.

This experiment tested the effects of alcohol and expectancies on determinants of safer sex according to the information-motivation-behavioral skills model. Sixty heterosexual women attended 2 sessions. During Session 1, participants completed a set of descriptive measures; during Session 2 they were randomly assigned to 1 of 4 beverage conditions: control, alcohol-low (.35 gm alcohol/kg body weight), alcohol-moderate (.70 gm alcohol/kg body weight), or placebo. After beverage consumption, all participants completed measures of motivation to engage in risky sex and condom use negotiation skills. Results showed that the higher dose of alcohol and stronger alcohol expectancies were associated with greater motivation to engage in risky sexual behavior. However, perceived intoxication, rather than actual alcohol consumption or expectancies, was the best predictor of condom use negotiation skills. Integration of the findings with past research and their implication for the design of HIV-prevention programs are discussed.

Adult↗

PubMed1990

Risk perceptions and participation in colorectal cancer screening.

Compared individuals at high versus average risk for colorectal cancer (CRC) with respect to factors they cited as affecting their risk of developing CRC. We also examined the relationship of these risk-factor perceptions to perceived susceptibility and participation in a CRC screening test. All individuals in the high-risk group were informed that, as a sibling of someone with CRC, they were more likely to get this cancer themselves. We found minimal differences among siblings with respect to perceived susceptibility. Further, although high-risk siblings were more likely to participate in screening, only 20.2% cited heredity as a risk-increasing factor, and, among these siblings, there was no relationship between screening participation and the citation of any specific risk factors, including heredity. These findings demonstrate the need for more research examining how high-risk individuals process risk-relevant information and the effect of this information on health behavior.

Adult↗

PubMed2006

Responding to global infectious disease outbreaks: lessons from SARS on the role of risk perception, communication and management.

With increased globalisation comes the likelihood that infectious disease appearing in one country will spread rapidly to another, severe acute respiratory syndrome (SARS) being a recent example. However, although SARS infected some 10,000 individuals, killing around 1000, it did not lead to the devastating health impact that many feared, but a rather disproportionate economic impact. The disproportionate scale and nature of this impact has caused concern that outbreaks of more serious disease could cause catastrophic impacts on the global economy. Understanding factors that led to the impact of SARS might help to deal with the possible impact and management of such other infectious disease outbreaks. In this respect, the role of risk--its perception, communication and management--is critical. This paper looks at the role that risk, and especially the perception of risk, its communication and management, played in driving the economic impact of SARS. It considers the public and public health response to SARS, the role of the media and official organisations, and proposes policy and research priorities for establishing a system to better deal with the next global infectious disease outbreak. It is concluded that the potential for the rapid spread of infectious disease is not necessarily a greater threat than it has always been, but the effect that an outbreak can have on the economy is, which requires further research and policy development.

Communicable Diseases↗

PubMedDate not supplied

Importance of psychological variables in understanding risk perceptions and breast cancer screening of African American women.

African American women are less likely than white women to receive and perform adequate breast screening, and represent a group that has not been thoroughly researched in the area of breast cancer risk. In general, perceptions of risk and worry about cancer are both related to obtaining mammography and possibly other screening activities. We examine African American women's worry and beliefs about breast cancer, and their intentions to perform breast and genetic screening behaviors, using the self-regulatory model. Participants were recruited via media announcements; they completed questionnaires addressing several aspects of the self-regulatory model. Forty-one percent of participants were underestimators, 23% were overestimators, and 37% were extreme overestimators of their own personal risk for breast cancer. Several variables were significant predictors of willingness to undergo mammography and genetic screening, including ethnic identity, attitudes toward the physician, emotional distress, and risk overestimation. These data highlight the importance of psychological variables in understanding screening in African American women and hold promise for intervention design.

Adult↗

PubMed2006

Risk perception and attitudes towards HIV in Serbian health care workers.

BACKGROUND: Health care workers (HCWs) are at risk of occupational exposure to human immunodeficiency virus (HIV). AIM: To investigate the perception of professional risk from, and the knowledge, attitudes and practice of HCWs to HIV and AIDS in Serbia. METHODS: Cross-sectional study of 1,559 Serbian HCWs using self-administered anonymous questionnaires. Chi-square testing and multiple logistic regression analysis were applied. RESULTS: Eighty-nine per cent of HCWs believed that they were at risk of acquiring HIV through occupational exposure. The perception of professional risk was higher among HCWs frequently exposed to patients' blood and body fluids (OR 7.9, 95% CI 4.4-14.5), who used additional personal protection if the HIV status of patient was known (OR 2.6, 95% CI 1.5-4.6), who had experienced sharp injuries within the last year (OR 1.9, 95% CI 1.0-3.8) or who had been tested for HIV (OR 2.1, 95% CI 1.2-3.5), and among HCWs who had treated HIV-positive patients (OR 1.7, 95% CI 1.1-2.8). The majority of respondents had deficient knowledge about modes of HIV transmission. Attitudes towards HIV-positive patients were significantly different by occupation. Seventy per cent of HCWs used appropriate protection during their daily work with patients. CONCLUSIONS: HCWs require specific educational programmes and training protocols to ensure that they are adequately protected when carrying out high quality care.

Adult↗