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PubMed1996

Perceived risk, anxiety, mammogram uptake, and breast self-examination of women with a family history of breast cancer: the role of knowing to be at increased risk.

Since women with a first-degree relative with breast cancer are at increased risk for breast cancer, it is of special importance that they adhere to early detection programs. In this study, women with (389) and without (3295) a family history of breast cancer were compared with respect to risk perception, breast cancer anxiety, and early detection behavior. Special attention was paid to the role of knowing that family history is a breast cancer risk factor. It was found that 46% of "family history positives" did not know that their risk was increased by their family history. Still, family history positives had increased risk perception; our results suggest that this was partly caused by their knowing they belonged to a risk group and partly by their having experienced the disease at close range. Although family history positives had higher risk perceptions, no differences in early detection behavior were found. This could not be attributed to high anxiety levels. Implications for health education are discussed.

Anxiety↗
PubMed2004

Impacts of beach closures on perceptions of swimming-related health risk in Orange County, California.

Following a major beach closure due to bacterial contamination, a survey of beachgoers was conducted in Huntington Beach, California in 1999 to assess perceived health risk from swimming. Responses were compared to those of beachgoers at the unaffected Laguna Main Beach. No significant differences were found in risk perception. Respondents were aware of the closures (83%), yet the majority (83%) felt the water was safe for swimming. Proximity of residence to the beach was strongly associated with closure awareness (Spearman's rho=0.427, p<0.0001). Although 83% of respondents felt that water quality was important in deciding to go to the beach, only 25% of respondents who did not plan to swim cited pollution or contamination as a reason not to swim. Most respondents (70%) trusted local health agency officials' decisions about when to open/close beaches. Surveyed beach visitors were likely to bathe (84%) and were not highly concerned with swimming-related health risks.

Adult↗
PubMed2006

Development of a communication aid to facilitate risk communication in consultations with unaffected women from high risk breast cancer families: a pilot study.

UNLABELLED: The literature on risk perception in women from high-risk breast cancer families reveals persistent over-estimation of risk, even after counseling. In this study, a communication aid was designed to facilitate discussion of risk between clinical geneticists and genetic counselors and women from this high-risk population. METHOD: Stage 1. The aid was developed by an expert panel of clinical geneticists, genetic counselors, psychologists, an epidemiologist, an oncologist, linguists and a consumer. It was guided by the international literature on risk communication and a large multi-centre Australian study of risk communication. The 13 page full-color communication aid used varying formats of words, numbers, graphs and pie-charts to address (a) the woman's subjective risk; (b) the population risk of breast cancer; c) the risk of inherited breast cancer; (d) the cumulative risk for women with BRCA1 and BRCA2 mutations; (e) family risk factors; (f) the woman's suitability for genetic testing; (h) screening and management recommendations, and (i) a re-assessment of the woman's subjective risk. Stage 2: A before-after pilot study of 38 women who were unaffected with breast cancer and were attending four Australian familial cancer clinics was undertaken. Baseline and follow-up questionnaires were completed by 27 women. Outcomes were compared to those observed in 107 similar women undergoing genetic counseling without the communication aid in 2001. RESULTS: The risk communication aid appears to be beneficial; breast cancer genetics knowledge improved in some areas and importantly, risk perceptions improved in the cohort receiving the communication aid. Psychological measures showed no difference in anxiety or depression between the group receiving the communication aid and the comparison cohort. Women and clinicians were very positive about the usefulness of the communication aid as an adjunct to the genetic counseling consultation.

Australia↗
PubMed1997

Responses to occupational hazards: exit and participation.

The authors developed and tested a model linking subjective risk perceptions to both turnover intentions and employees' willingness to participate in health and safety programs. On the basis of data from 130 employees of a manufacturing firm, the model was supported. Risk perceptions were predicted by employees' accident history and perceptions of others' commitment to health and safety. In turn, risk perceptions predicted both turnover intentions and willingness to participate. These effects emerged after controlling for monomethod bias.

Accidents, Occupational↗
PubMed2006

General practitioners' perception of risk factors for cervical cancer development: consequences for patient education.

OBJECTIVE: The introduction of human papillomavirus (HPV) detection in cervical screening will make it necessary to provide appropriate information to the general public. Only 3% of Flemish women could name HPV as the viral agent involved in cervical cancer development. The aim of this study was to investigate whether general practitioners (GPs) have appropriate knowledge of the relationship between HPV and cervical cancer to be able to inform women. METHODS: A questionnaire was developed to measure perception of 20 risk factors for cervical cancer development, on a scale of 1 (unimportant) to 5 (very important). Respondents were also asked to give an estimate of the chances of survival for women, diagnosed with cervical cancer detected by screening. RESULTS: Sixty GPs and 28 trainees filled in the questionnaire. The five most important risk factors in the perception of the respondents were, in order of decreasing importance, viral infection, number of sex partners, sexual behaviour of the partner, unsafe sex, and early start of sexual activity. Fifty-six percent of the GPs expected the chance of survival to be between 80 and 100%, compared to only 31% of the trainees. CONCLUSION: Most GPs are well aware of sexual habits as risk factors for cervical cancer development, including the role of HPV as the viral agent in the etiology. However, they seem to underestimate the role of smoking and are unable to identify the correct chance of survival for women in whom cervical cancer is detected within the frame of the cervical smear program. PRACTICE IMPLICATIONS: Attention should be given to education of medical students and practitioners, in order to allow them to supply patients with sufficient background information to make an informed choice on participating in cervical cancer screening.

Attitude of Health Personnel↗
PubMed2003

'Double or quits': perceptions and management of organ transplantation by adults with cystic fibrosis.

Medical sociologists have often considered lay perceptions of the risks of medical interventions, yet in many empirical studies respondents are people who are not likely to be exposed to a particular intervention. Furthermore, it has been well documented that risk perceptions may change over time and with diminishing health state. This paper explores perceptions and management of the risks of organ transplantation amongst adults with cystic fibrosis (CF), the most common autosomal recessive genetic disease in the UK. Although the focus of medical research is now on providing gene replacement therapy to this group, transplantation is currently the last treatment that an adult with CF can be offered when all other treatment has failed to maintain their health. Thirty-one respondents with varying degrees of health state from a specialist CF centre were interviewed as part of a larger study concerning perceptions of health and risks of treatment. Interviews were audiotaped, transcribed and analysed using ATLAS-ti. During analysis respondents' transcripts were divided into two groups: firstly those who did not anticipate needing a transplant in the near future (if at all) and secondly those who were currently being considered for transplantation, on the transplant list, or who had already received donor organs. The paper focuses on themes arising from interview transcripts and finds that although the focus of risk differs between the two groups, the influence of luck is perceived as strong for both groups and emotion work features heavily in those undergoing the transplant process. Contrary to previous research, fears of inheriting donor characteristics are not found amongst adults with CF, but rather body components are commodified when talking of both giving and receiving organs.

Adult↗
PubMed2000

Mothers and daughters from breast cancer families: a qualitative study of their perceptions of risks and benefits associated with minor's participation in genetic susceptibility research.

OBJECTIVES: To determine: 1) the views of daughters at increased risk of developing breast cancer regarding the benefits and risks of participating in genetic susceptibility research; 2) mothers' views about enrolling their daughters in genetic susceptibility research; and 3) any important areas of agreement and disagreement between mothers and daughters in their assessment of risks and benefits. METHODS: We conducted separate interviews of mothers and daughters from 12 breast cancer families recruited primarily through the Breast Center at Johns Hopkins University. Daughters were between the ages of 10 and 17. Interviews were transcribed and coded and analyzed qualitatively. RESULTS: We observed that mothers and daughters had a range of reactions to the prospect of enrolling children and adolescents in genetic susceptibility research, that perceptions of benefits and risks were fairly concordant between mothers and daughters, and that daughters initially identified no risks of participating, but their perceptions of the risks and benefits of genetic susceptibility research evolved over the course of conversation. CONCLUSION: These findings underscore the view that informed consent ought to be a "process" rather than a single event, and that children's first reactions to the prospect of participating in genetic testing research should not be taken as evidence that they have adequately considered the risks and benefits of participation.

Adolescent↗
PubMed2006

Smoking-associated factors in myocardial infarction and unstable angina: do gender differences exist?

The aim of this study was to investigate demographic and psychological characteristics associated with smoking in patients with acute coronary syndrome (myocardial infarction or unstable angina). Interviews were conducted with 348 consecutive hospitalized patients with acute coronary syndrome and included questions about demographic characteristics, coffee consumption, heart disease risk perception, economic status, alcohol consumption, depression, anxiety, and stress. Female group multivariate analysis showed that smoking in females was significantly and negatively associated with age, heart disease risk perception, and positively associated with coffee consumption. Male group multivariate analysis showed that for males, smoking was significantly and negatively associated with age, heart disease risk perception, and positively associated with coffee and alcohol consumption. Unlike studies conducted with non-heart disease patients, our results do not show an association between smoking and depression. Compared with nonsmokers, smokers with acute coronary syndrome are younger, more likely to drink coffee, and less likely to perceive smoking as a heart disease risk. Male smokers are also more likely to drink alcohol, indicating that they use more psycho-stimulants than do nonsmoking men and women who smoke.

Adult↗
PubMed1992

Perception of risk for malaria and schistosomiasis in rural Malawi.

A sample of 120 individuals--representative of the Malawian population in terms of gender and age distribution--were interviewed regarding their perceptions of the diseases malaria and schistosomiasis. Particular attention was paid to judgements regarding the level, seriousness, predictability and controllability of these health risks. Sample sites were lowland marshland areas where both diseases were highly prevalent. Individuals were also asked about their adherence to recommended malaria and schistosomiasis control and prevention procedures. Respondents commonly rated malaria and schistosomiasis both unpredictable and uncontrollable. For malaria, no risk judgements predicted level of adherence to prevention guidelines. That is, individuals' perception of malaria risk bore no influence on whether or not they engaged in recommended behaviour. For schistosomiasis, seriousness of infection (at one sample site) and the predictability and controllability of infection (at the other sample site) predicted such adherence. Analysis of the influence of factors such as age, gender and level of education confirmed distinct patterning or responses for the two health risks. Whilst adherence to preventative guidelines for schistosomiasis is influenced by personal perceptions of risk, it appears that social factors may exert more influence on the extent of compliance with malaria control and prevention procedures. Distinct approaches to health education regarding malaria and schistosomiasis may, therefore, be warranted, with the former emphasising community responsibility and participation, and the latter individual actions which may reduce risk.

Attitude to Health↗
PubMed1999

Taking behavioralism seriously: some evidence of market manipulation.

Over the last ten to fifteen years, economists and legal scholars have become increasingly interested in and sensitive to behavioralist insights. In a companion article, Jon Hanson and Douglas Kysar argued that those scholars have nevertheless given short shrift to what is, at least for policymaking purposes, perhaps the most important lesson of the behavioralist research: individuals' perceptions and preferences are highly manipulable. According to Hanson and Kysar, one theoretical implication of that insight for products liability law is that manufacturers and marketers will manipulate the risk perceptions of consumers. Indeed, to survive in a competitive market, manufacturers and marketers must do so. In this Article, Hanson and Kysar present empirical evidence of market manipulation--a previously unrecognized source of market failure. The Article begins by surveying the extensive qualitative and quantitative marketing research and consumer behavioral studies that discern and influence consumer perceptions. It then provides evidence of market manipulation by reviewing common practices in everyday market settings, such as gas stations and supermarkets, and by examining familiar marketing approaches, such as environmentally oriented and fear-based advertising. Although consumers may be well-aware of those practices and approaches, they appear to be generally unaware of the extent to which those tactics are manipulative. The Article then focuses on the industry that has most depended upon market manipulation: the cigarette industry. Through decades of sophisticated marketing and public relations efforts, cigarette manufacturers have heightened consumer demand and lowered consumer risk perceptions. Because consumers are aware that smoking may pose significant health risks, the tobacco industry's success in manipulating risk perceptions constitutes especially strong evidence of the power of market manipulation. The Article concludes by arguing that the evidence of market manipulation may justify moving to a regime of enterprise liability. Indeed, according to Hanson and Kysar, the evidence of market manipulation confirms the intuitions of the first generation of product liability scholars, who worried about manufacturers' power to manipulate and called for just such a regime.

Advertising↗
PubMed1997

Perception of risk, choice of maternity site, and socio economic level of twin mothers.

The objective of this study was to determine if access to high level health facility (level 3 perinatal center) is related to socio-economic level of the mother and to her perception of risk for a twin birth. A retrospective questionnaire was administrated to the mothers of twins during the first post parum days in each of the 27 maternity sites within a defined geographical district near Paris (Hauts de Seine). The survey instrument was designed to precisely characterize the socioeconomic status of the parents, to measure the perceived risk for the twins expressed by the mother, to measure the relationship between the choice of a maternity site (level 1, 2 or 3) by socioeconomic level, and to measure the fetal and neonatal death rates by socioeconomic status. The opinion of mothers of twins about specific risk for her and for her children is very different by socioeconomic levels, as is the choice of level 3. This is discussed with the rates of fetal and neonatal death rates by socioeconomic level. In the absence of a policy of regionalization of perinatal care, the discriminant factor for access to high level care (level 3 maternity site) is the socioeconomic level.

Cohort Studies↗
PubMed2005

Correlates of motivation to prevent weight gain: a cross sectional survey.

BACKGROUND: This study is an application of the theory of planned behaviour (TPB) with additional variables to predict the motivations to prevent weight gain. In addition, variations in measures across individuals classified into Precaution Adoption Process stages (PAPM-stages) of behaviour change were investigated. METHODS: A cross-sectional survey among 979 non-obese Dutch adults aged 25-35 years was conducted. Multiple binary logistic regression analysis was conducted to assess the associations of Body Mass Index (BMI), demographic factors and psychosocial variables from the TPB with the intention to prevent weight gain. Differences in BMI, demographic and psychosocial factors between PAPM-stages were explored using one-way analysis of variance and chi-square tests. RESULTS: Eighty-five percent of respondents intended to prevent weight gain. Age, attitudes and risk perceptions related to weight gain were the strongest correlates of intention (age: OR = 1.12, 95%CI: 1.04-1.20; attitude OR = 7.91, 95%CI: 5.33-11.74; risk perception OR = 1.24, 95%CI: 1.11-1.38). Significant differences were detected between the PAPM-stages in almost all variables. Notably, perceived behavioural control was lowest among people who had decided to prevent weight gain. CONCLUSION: Messages to influence attitudes towards the prevention of weight gain and risk perception may affect people who are not yet motivated to prevent weight gain. Interventions increasing people's perceived behavioural control in overcoming barriers to prevent weight gain may help people to act on their intentions.

Journal Article↗
PubMed2003

Investigating the influence of organizational role on perceptions of risk in deep coal mines.

The authors replicated O. Ostberg's (1980) study of forestry workers using a range of personnel groups in coal mines. Findings demonstrate a high level of consensus between a range of personnel groups for a set of pictorially depicted behavioral risks, at the level of rank order, but significant differences in terms of relative magnitudes. Magnitudes of perceived risk were found to be greater for those closest to the point of hazard than for members of more geographically and experientially distal groups. Findings are interpreted with reference to experiential influences associated with organizational role. Revealed differences between personnel groups are explained in terms of cognitive availability, specifically effects associated with habituation and familiarity with risk, these sources of perceptual bias appearing to interact with organizational role.

Coal Mining↗
PubMed2001

Foot care practices, services and perceptions of risk among medicare beneficiaries with diabetes at high and low risk for future foot complications.

A cohort of Medicare beneficiaries with diabetes was identified from inpatient and outpatient claims data and their risk for foot complications was estimated based on claims reflecting services for recent foot problems. A telephone survey of a random sample from this cohort was conducted to assess their foot care practices, barriers, and perceptions of risk. Eight percent of respondents reported a history of foot ulcers and 7% a history of lower extremity amputation. Based on claims data, 30% of respondents were at high risk for future foot complications. Compared to those at low risk, those at high risk were more likely to report having an annual foot exam, using protective footwear, and perceiving themselves to be high risk for future foot complications. However, 50% of those with claims indicating a high risk perceived themselves to be at low risk for future foot complications. Overall, 20% of respondents seldom checked their feet daily for sores or irritations. Among this group, 60% felt that it was unimportant and 9% reported they were limited by poor vision or physical problems. Our findings suggest that strategies are needed to improve the delivery of preventive foot care services to older persons with diabetes. Additionally, emphasis is needed to help individuals understand their risk and seek and perform appropriate preventive foot care.

Aged↗
PubMed2003

Misperceived risk among female adolescents: social and psychological factors associated with sexual risk accuracy.

This study of 411 urban female adolescents had 3 objectives: (a) assess the relationship between perceived risk and sexual risk behavior (condom use, number of partners, partner risk, presence of STDs, and aggregate sexual risk), (b) assess the accuracy of risk perceptions, and (c) identify variables related to inaccurate sexual risk perceptions. Participants were classified as accurate or inaccurate risk perceivers on the basis of actual sexual behavior and perceived risk. Accurate versus inaccurate risk perceivers were compared on psychological maintenance variables (self-esteem, distress, and coping), relationship context variables (partnership duration and pressure to have unprotected sex), and risk knowledge at different levels of sexual risk. Approximately half of the participants underestimated the risk of their sexual behavior. Accurate and inaccurate risk perceivers differed on risk knowledge, partnership duration, and pressure to have unprotected sex.

Adolescent↗
PubMed2004

Signal crimes and signal disorders: notes on deviance as communicative action.

In this paper a 'signal crimes' perspective is outlined in an effort to unpack the relationships between experiences of crime and disorder, and perceptions of criminogenic risk. Grounded in symbolic interactionist sociology, and developing a social semiotic understanding of risk perception, it is a perspective that focuses upon processes of social reaction and the ways in which people interpret and define threats to their security. It is proposed that people interpret the occurrence of certain incidents as 'warning signals' about the levels of risk to which they are either actually or potentially exposed. These signals tend to take the form of signal crimes and/or signal disorders and are important in terms of how social space is symbolically constructed.

Crime↗
PubMed2002

Risk analysis and risk management in an uncertain world.

The tragic attacks of September 11 and the bioterrorist threats with respect to anthrax that followed have raised a set of issues regarding how we deal with events where there is considerable ambiguity and uncertainty about the likelihood of their occurrence and their potential consequences. This paper discusses how one can link the tools of risk assessment and our knowledge of risk perception to develop risk management options for dealing with extreme events. In particular, it suggests ways that the members of the Society for Risk Analysis can apply their expertise and talent to the risks associated with terrorism and discusses the changing roles of the public and private sectors in dealing with extreme events.

Awards and Prizes↗