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Familial breast cancer: a controlled study of risk perception, psychological morbidity and health beliefs in women attending for genetic counselling.

The present study set out to evaluate perceptions of risk, psychological morbidity and health behaviours in women with a family history of breast cancer who have attended genetic counselling and determine how these differ from general population risk women. Data were collected from 62 genetic counselees (cases) attending the Royal Marsden and Mayday University Hospital genetic counselling services and 62 matched GP attenders (controls). Levels of general psychological morbidity were found to be similar between cases and controls; however, cases reported significantly higher breast cancer-specific distress despite clinic attendance [mean (s.d.) total Impact of Event Scale score, 14.1 (14.3) cases; 2.4 (6.7) controls, P < 0.001]. Although cases perceived themselves to be more susceptible to breast cancer, many women failed correctly to recall risk figures provided by the clinic; 66% could not accurately recall their own lifetime chance. Clinics appeared to have a positive impact on preventive behaviours and cases tended to engage more regularly in breast self-examination (monthly, 66% of cases vs 47% of controls), although few differences were found between groups in terms of health beliefs. We conclude that counselees and GP controls showed considerable similarities on many of the outcome measures, and risk of breast cancer was not predictive of greater psychological morbidity; although cases were more vulnerable to cancer-specific distress. Despite genetic counselling, many cases continued to perceive their risk of breast cancer inaccurately.

Adult↗

[Knowledge and risk perception of HIV/AIDS: a profile of the Brazilian people in 1998].

This paper focuses on cognitive aspects related to HIV/AIDS by presenting distinct subgroups of the Brazilian population. Four subgroups were created according to their different levels of knowledge regarding HIV/AIDS and risk perception: subgroup 1 (no awareness and no risk perception); subgroup 2 (no awareness, with some risk perception); subgroup 3 (some awareness and no risk perception); and subgroup 4 (some awareness and some risk perception). The data come from the National Survey on Sexual Behavior and HIV/AIDS Risk Perception in the Brazilian Population, conducted by CEBRAP (the Brazilian Analysis and Planning Agency) together with the Ministry of Health, in 1998. The study highlights that in 1998, slightly over half of the Brazilian population were minimally aware of HIV transmission processes. Analysis of demographic and socioeconomic characteristics associated with protective behavior against HIV/AIDS showed that approximately 23% of the study population belonged to subgroup 1 - with no awareness and no risk perception - and were thus highly vulnerable to infection.

Acquired Immunodeficiency Syndrome↗

Risk perception of heavy metal soil contamination by high-exposed and low-exposed inhabitants: the role of knowledge and emotional concerns.

Soil contaminated with heavy metals is a salient example of environmental risk. Consumption of vegetables cultivated in contaminated soil or direct ingestion of soil by small children can damage health. In contrast to other kinds of pollution or risks such as air pollution or exposure to ozone, the individual risk concerning soil contamination is highly dependent on the way one is exposed to the local source of risk. Thus, we wanted to know if risk perception varies according to the level of exposure. A quasi-experimental, questionnaire-based study was conducted in a community in northwest Switzerland, where the soil is widely contaminated. The level of contamination varies with the distance from the source of the contamination, a metal processing plant. We investigated the perception of risk of heavy-metal-contaminated soil by inhabitants with high-exposure levels (N= 27) and those with low-exposure levels (N= 30). Both groups judged the risk for oneself similarly whereas the low-exposure group, when compared to the high-exposure group, judged perceived risk for other affected people living in their community to be higher. Besides this exposure effect, risk perception was mainly determined by emotional concerns. Participants with higher scores in self-estimated knowledge tended to provide low-risk judgments, were less interested in further information, showed low emotional concern, and thus displayed high risk acceptance. In contrast, actual knowledge showed no correlation with any of theses variables. Judgments on the need for decontamination are determined by risk perception, less application of dissonance-reducing heuristics and commitment to sustainability. The desire for additional information is not affected by missing knowledge but is affected by emotional concerns.

Emotions↗

American risk perceptions: is climate change dangerous?

Public risk perceptions can fundamentally compel or constrain political, economic, and social action to address particular risks. Public support or opposition to climate policies (e.g., treaties, regulations, taxes, subsidies) will be greatly influenced by public perceptions of the risks and dangers posed by global climate change. This article describes results from a national study (2003) that examined the risk perceptions and connotative meanings of global warming in the American mind and found that Americans perceived climate change as a moderate risk that will predominantly impact geographically and temporally distant people and places. This research also identified several distinct interpretive communities, including naysayers and alarmists, with widely divergent perceptions of climate change risks. Thus, "dangerous" climate change is a concept contested not only among scientists and policymakers, but among the American public as well.

Journal Article↗

Risk perceptions and First Nations communities.

When conducting research in First Nations communities problems can arise when applying research methods that were developed for Western society. Studies of environmental risk perception, the subfield of environmental risk assessment and management that incorporates the opinions and feelings of "lay persons" into the assessment process, are not immune to this. These studies of risk perception are generally based on statistical analyses derived from questionnaires. This paper will argue that the methodology used in studying the perception of risk of First Nations people should be culturally sensitive to the particular community that is being studied. This can be accomplished with direct community approval and cooperation from the initial decision on whether or not a study is needed, the research itself, and finally the communication of results. This paper is not meant to be a critique of the field of risk perception, but is instead a discussion of the characteristics of community-based research relevant to the field of risk perception.

Alberta↗

Consumer risk perceptions toward agricultural biotechnology, self-protection, and food demand: the case of milk in the United States.

This study is an econometric systems approach to modeling the factors and linkages affecting risk perceptions toward agricultural biotechnology, self-protection actions, and food demand. This model is applied to milk in the United States, but it can be adapted to other products as well as other categories of risk perceptions. The contribution of this formulation is the ability to examine how explanatory factors influence risk perceptions and whether they translate into behavior and ultimately what impact this has on aggregate markets. Hadden's outrage factors on heightening risk perceptions are among the factors examined. In particular, the article examines the role of labeling as a means of permitting informed consent to mitigate outrage factors. The effects of attitudinal, economic, and demographic factors on risk perceptions are also explored, as well as the linkage between risk perceptions, consumer behavior, and food demand. Because risk perceptions and self-protection actions are categorical variables and demand is a continuous variable, the model is estimated as a two-stage mixed system with a covariance correction procedure suggested by Amemiya. The findings indicate that it is the availability of labeling, not the price difference, between that labeled milk and milk produced with recombinant bovine Somatotropin (rbST) that significantly affects consumer's selection of rbST-free milk. The results indicate that greater availability of labeled milk would not only significantly increase the proportion of consumers who purchased labeled milk, its availability would also reduce the perception of risk associated with rbST, whether consumers purchase it or not. In other words, availability of rbST-free milk translates into lower risk perceptions toward milk produced with rbST.

Agriculture↗

The effects of mood on managerial risk perceptions: exploring affect and the dimensions of risk.

The effects of managerial mood on situational risk perceptions were tested among 85 managers from a variety of organizations, industries, and positions in Singapore. A risk-assessment scenario was developed that systematically varied the risk dimensions of outcome uncertainty, potential gains and losses, situational framing, and personal expectations. Negative, neutral, and positive moods were induced by having managers recall and describe work events. As affective state became more positive, managers perceived situational framing as more positive, and their beliefs that they could influence risky outcomes increased. Additionally, positive affect increased the likelihood that people who perceived situations as risky would select riskier courses of action.

Adult↗

Risk perception of participants in a family-based genetic screening program on familial hypercholesterolemia.

The aim of this article is threefold. First, we describe the accuracy of people's risk perception who have been screened on familial hypercholesterolemia (FH) in a family-based screening program. Second, we identify factors that modify risk perception. Finally, we show the influence of risk perception on subsequent preventive behavior. The risk perception of 556 screenees (677 participants, overall response = 82%) was measured by postal questionnaires on three occasions: at screening and 3 days and 7 months after the test result was reported to the patient. Presentation of the risk was precategorized and given both as numerical (1 in x) and as verbal probability. In addition, medication use and attitudes toward gene therapy were determined 7 months after screening. On average, the screenees underestimated their numeric risk of having FH and getting a myocardial infarction (MI). Furthermore, FH-positive screenees perceived that they were at greater risk of MI than FH negatives, and screenees with the highest actual risk used medication more, perceived a greater risk, and opted more often for future gene therapy. Risk perception of having FH was influenced by cholesterol level, while MI risk perception was affected by age, education, cholesterol level, and cardiovascular disease (CVD) in the family. We conclude that FH-positive screenees correctly perceive a higher risk of getting a heart attack than do FH-negative screenees. Screenees did not believe that MI was inevitable, and risk perception was associated with both medication use and the intention to opt for gene therapy, but not with other preventive measures. Thus, genetic risk notification seems to be acceptable and does not lead to aversion to preventive behavior.

Adolescent↗

A survey of physicians' vaccine risk perception and immunization practices for subjects with immunological diseases.

Various publications have caused concern by implying that immunization may be linked to new cases or flare-ups of immunological diseases (IDs). In view of the resulting uncertainty, we studied physicians' vaccine risk perception and immunization practices for adults with IDs. A questionnaire was mailed to three groups of physicians in France: internal medicine specialists, general practitioners, and travel clinic physicians. Thirteen vaccines currently used for adults in France were studied. Risk perception was rated on a 10 cm visual analog scale (VAS). The distribution of the answers was compared between and within groups of physicians. Potential associations between risk perception and reported practices were investigated by multivariate analysis. In the three groups of physicians (n=762), the tetanus and Salk poliomyelitis vaccines had the lowest risk perception. The yellow fever, BCG and Sabin poliomyelitis vaccines were the least well perceived. The distribution of risk perception for these three live vaccines and the hepatitis B vaccine was uniform according to VAS grading. For the other vaccines studied, the distribution was skewed to the low-risk perception side of the VAS. Risk perception was greater for physicians who stated: (1) that certain IDs carried a high risk of adverse events following immunization; (2) that they sought the advice of the referent physician before immunization; (3) warned their patients of the risk of an ID flare-up after vaccination; (4) sought information about recent immunization in patients with a flare-up; and (5) had experience of the side effects of immunization in adults with ID. Risk perception was lower for physicians who said they updated immunizations, and for the internists. The worse the vaccine risk perception by physicians, the more uniform the distribution of perception, thus reflecting the disagreement of the scientific community about the risk of using such vaccines for adults with an ID. Risk perception and immunization practices were related in adults with ID. Understanding of decisions concerning immunization may help to improve immunization updating and prevent risk amplification when evidence is lacking.

Adult↗

The function of credibility in information processing for risk perception.

This study examines how credibility affects the way people process information and how they subsequently perceive risk. Three conceptual areas are brought together in this analysis: the psychometric model of risk perception, Eagly and Chaiken's heuristic-systematic information processing model, and Meyer's credibility index. Data come from a study of risk communication in the circumstance of state health department investigations of suspected cancer clusters (five cases, N = 696). Credibility is assessed for three information sources: state health departments, citizen groups, and industries involved in each case. Higher credibility for industry and the state directly predicts lower risk perception, whereas high credibility for citizen groups predicts greater risk perception. A path model shows that perceiving high credibility for industry and state-and perceiving low credibility for citizen groups-promotes heuristic processing, which in turn is a strong predictor of lower risk perception. Alternately, perceiving industry and the state to have low credibility also promotes greater systematic processing, which consistently leads to perception of greater risk. Between a one-fifth and one-third of the effect of credibility on risk perception is shown to be indirectly transmitted through information processing.

Journal Article↗

Black-white differences in risk perceptions of breast cancer survival and screening mammography benefit.

BACKGROUND: Given differences in cancer survival by race, black women may differ from white women in breast cancer risk perceptions. OBJECTIVE: To evaluate black-white differences in risk perceptions of breast cancer survival and screening mammography benefit. DESIGN: A written survey was administered to a random sample of women attending general internal medicine clinics. PARTICIPANTS: Black and white women, ages 40 to 69. MEASUREMENTS: Risk perceptions were measured regarding (1) average 5-year survival after a breast cancer diagnosis and (2) relative risk reduction of screening mammography. Women's risk perceptions were defined as being accurate, as well as more or less pessimistic. Measured patient characteristics included race, age, family history of breast cancer, income, insurance, education, and numeracy. Unadjusted Pearson chi(2) tests and adjusted multivariable regression analyses were done. RESULTS: Black women were more likely than white women to accurately perceive breast cancer survival in both unadjusted (48% vs 26%, P<.001) and adjusted analyses (adjusted odds ratio (AOR)=3.58; 95% confidence interval (CI)=1.56 to 8.21). Black women were also more likely to accurately perceive the benefit of screening mammography in unadjusted (39% vs 15%, P<.001) and adjusted analyses (AOR=2.70; 95% CI=1.09 to 6.69). Black women were more likely to have a more pessimistic perception of mammography benefit in unadjusted (47% vs 15%, P<.0001) and adjusted analyses (AOR=3.94; 95% CI=1.62 to 9.56). CONCLUSIONS: Awareness of risk perceptions can help physicians to tailor patient education. Physician acknowledgment of more accurate risk perceptions among black women may serve as a basis to improve patient-physician communication.

Adult↗

Risk perceptions, condom use, and sexually transmitted diseases among adolescent females according to social network position.

BACKGROUND AND OBJECTIVES: Adolescent females are frequently treated as a homogenous group but could differ on their sexually transmitted disease (STD) risk because of individual attitudes and exposure through sexual networks. GOAL: The goal of this study was to determine if risk perceptions, condom use, and STD prevalence differs within sexual networks. STUDY DESIGN: Three hundred three adolescent females participating in a longitudinal study of adolescent STD risk perceptions and condom use were categorized as "core," "bridge," and "periphery" in a sexual network according to their and their main sex partner's risk information. Regression analysis determined differences in risk perceptions by network location. RESULTS: We demonstrated an inverse relationship between STD risk perceptions and network location. Adolescents with higher risk perceptions were more likely to use condoms, irrespective of network location. CONCLUSION: Female adolescents are a heterogeneous group exhibiting different risk perceptions. Different intervention strategies for adolescents at higher risk could be necessary. Interventions designed to raise risk perceptions could be associated with condom use, even for those adolescents at greatest risk.

Adolescent↗

Risk perception of traffic participants.

This article analyzes the risk perception of traffic participants by making use of Prospect Theory. This methodology makes a conceptual distinction between the perception of risk and the perception of the outcome of an uncertain event. In the field of transport safety such a distinction is desirable, because risks are typically very low and thus sensitive to misperception by traffic participants. Taking into account such misperception will significantly improve estimates of the valuation of transport safety. The first empirical results show that the valuation of losses is well represented by a utility function that is concave in shape. Secondly, our preliminary results show that individuals base their choice mainly on the possible outcomes and not so much on probabilities whenever there are very small probabilities (say <or=1/100) and "bad outcomes" involved.

Accidents, Traffic↗

Trust and risk perception in western Europe: a cross-national study.

The relationship between trust and risk perception was investigated, within and across four European countries (Sweden, Spain, United Kingdom, and France). Survey data were collected in 1996; total number of respondents was approximately 1,000 (United Kingdom and Spain), 1,350 (France), and 2,050 (Sweden). Trust was a significant predictor of perceived risk within countries, but the strength of the relationship varied from weak (Spain and France) to moderate (United Kingdom and Sweden). General trust was also a significant source of variation in perceived risk among countries, but much of the variation in perceived risk remained unexplained. Correlations between trust and risk perception also varied depending on the type of risk (i.e., nuclear risks were more influenced by trust) and trust measure (i.e., general trust explained perceived risk better than specific trust). It is concluded that trust may be an element in models explaining risk perception, but it is not as powerful as often argued in the risk perception literature.

France↗

Chronic exposure to an environmental hazard: risk perceptions and self-protective behavior.

The risk perceptions and self-protective behavior of 282 immigrant farm workers (all of Mexican origin) in response to pesticide exposure were examined. Several variables were predicted to influence reactions, but some deviations from past studies were expected because cultural or socioeconomic factors could modify risk responses. In keeping with predictions, greater risk perceptions were associated with beliefs that past harm had occurred, future harm to self or offspring was likely, precautions were less effective, and cancer-causing agents were mostly unavoidable. Self-protective behavior was most likely for those receiving risk information, having greater perceptions of control over health and the occupational situation, and believing that precautionary methods were effective. The discussion considers variability in responses to chronic risk and the broader perspective offered by environmental hazard studies.

Adolescent↗

Food risk perceptions, gender, and individual differences in avoidance and approach motivation, intuitive and analytic thinking styles, and anxiety.

Risks appear to be perceived in two different ways, affectively and rationally. Finnish adult internet users were contacted via e-mail and asked to fill an internet questionnaire consisting of questions of food risks and measures of avoidance and approach motivation, analytic and intuitive information processing style, trait anxiety, and gender in order to find out (1) whether food risks are perceived two-dimensionally, (2) how individual differences in motivation, information processing, and anxiety are associated with the different dimensions of food risk perceptions, and (3) whether gender moderates these associations. The data were analyzed by factor, correlation and regression analyses. Three factors emerged: risk scariness, risk likelihood, and risks of cardiovascular disease. Personality and gender x personality interactions predicted food risk perceptions. Results showed that food risk perceptions generally form two dimensions; scariness and likelihood, but that this may depend on the nature of the risk. In addition, results imply that individuals with high avoidance motivation perceive food risks as scarier and more likely than others, and that individuals with an analytic information processing style perceive food risks as less likely than others. Trait anxiety seems to be associated with higher food risk perceptions only among men.

Adolescent↗

Gail model risk assessment and risk perceptions.

Patients can benefit from accessible breast cancer risk information. The Gail model is a well-known means of providing risk information to patients and for guiding clinical decisions. Risk presentation often includes 5-year and life-time percent chances for a woman to develop breast cancer. How do women perceive their risks after Gail model risk assessment? This exploratory study used a randomized clinical trial design to address this question among women not previously selected for breast cancer risk. Results suggest a brief risk assessment intervention changes quantitative and comparative risk perceptions and improves accuracy. This study improves our understanding of risk perceptions by evaluating an intervention in a population not previously selected for high-risk status and measuring perceptions in a variety of formats.

Adult↗

Coping after cancer: risk perceptions, worry, and health behaviors among colorectal cancer survivors.

This study asks whether the experience of cancer motivates healthy behavior change. Further, we asked whether such changes relate to risk perceptions and worry, as suggested by Leventhal's Parallel Processing Model. Male (n=41) and female (n=40) survivors of colorectal cancer were interviewed 1-14 years after they first completed treatment. Younger age was associated with stronger risk perceptions, more worry, and greater anxiety. Shorter-term, compared to longer-term survivors, reported higher risk perceptions and more frequent intrusive thoughts. Greater perceived risk, worry and anxiety correlated positively with intentions to make positive health behavior changes. Overall, these survivors did not report exaggerated risk perceptions, and they were not overly worried or anxious about cancer recurrence. However, low-level risk perceptions, worry, and anxiety motivated interest in adopting protective health behaviors.

Adaptation, Psychological↗