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PubMed2004

Agreement between scales in the measurement of breast cancer risk perceptions.

The objective of this article is to compare the accuracy and numeric responses of breast cancer risk perception as measured by a frequency scale and percentage scale. A cross-sectional survey was conducted. Perceptions of five-year and lifetime breast cancer risk were measured using a frequency and a percentage scale. Estimation error was calculated as the absolute difference between actual breast cancer risk as determined by the Gail model and perceived risk. Agreement between scales was determined by calculating the mean and standard deviation of the difference between numeric responses. The study was conducted among women enrolled in two primary care clinics associated with an academic medical center. Two-hundred-fifty-four participants were recruited from one of the two participating internal medicine clinics. Inclusion criteria included female gender and age 40-84 years. Exclusion criteria included a history of breast cancer, dementia, or a life expectancy of less than two years. The frequency scale was more accurate than the percentage scale in estimating lifetime risk (p= 0.05), but less accurate in estimating five-year risk (p < 0.02). Only 79 participants (31%) were considered consistent scale users, providing identical responses when using the frequency and percentage scale for a given risk estimate. Although the mean difference (percentage-frequency scale) for estimates of breast cancer lifetime risk was only 2.4, the empirically determined 90% limits of agreement between the frequency and percentage scale for lifetime risk were wide, from -30 to 40. Higher numeracy was associated with consistent use of scales (OR 1.61, 95% CI; 1.09-2.37). We report disagreement in breast cancer risk perceptions when measured by a frequency and a percentage scale. The accuracy and direction of bias associated with each scale varies according to the time frame of risk being assessed.

Adult↗
PubMed2005

To test or not to test? Moderators of the relationship between risk perceptions and interest in predictive genetic testing.

The moderating effects of motivational factors (illness prevention vs. emotional reassurance), regulatory focus (health vs. illness orientations), and cancer anxiety on the relationship between risk perceptions and women's interest in predictive genetic testing for breast cancer were studied among 102 women with no history of breast cancer. Risk perceptions per se were unrelated to testing interests. Perceptions of higher personal risk for developing breast cancer were positively related to women's interest in testing only among women whose dominant motivation was not emotional reassurance, who were not oriented towards ruling-out disease, and who were not highly anxious about breast cancer. These findings pointed to conditions under which risk perceptions may enhance screening behaviors, and other conditions under which they may not.

Adult↗
PubMed2003

Breast cancer risk perception and surveillance: an integrative review.

PURPOSE: A family history of breast cancer has taken on new meaning with the advancement of genetic technology and the discovery of genes related to breast cancer risk. The purpose of this review is to summarize and synthesize current literature on breast cancer risk perception and mammography screening practices as related to women who have a first-degree relative with breast cancer. CONCLUSIONS: Research has shown that women tend to overestimate their breast cancer risk and that risk counseling fails to have a significant effect. Inconsistent findings exist in relation to the effect of family history on screening behaviors and conflicting evidence in the relationship between risk perception and mammography use. IMPLICATIONS: Inaccurate risk perceptions for high-risk women may be because of the inconsistent messages women are hearing in the media or from health care providers in regard to the efficacy of mammography. Practitioners need to be careful not to assume that a strong family history of breast cancer leads to increased perceived risk, which in turn promotes increased mammography use.

Breast Neoplasms↗
PubMed2004

Predictors of pessimistic breast cancer risk perceptions in a primary care population.

OBJECTIVE: To identify sociodemographic characteristics, numeracy level, and breast cancer risk factors that are independently associated with the accuracy of lifetime and 5-year breast cancer risk perceptions. DESIGN: Cross-sectional survey. A probability scale was used to measure lifetime and 5-year risk perceptions. The absolute difference between perceived risk and the Gail model risk of breast cancer was calculated. Linear regression models were built to predict lifetime and 5-year breast cancer risk estimation error. SETTING: Primary care internal medicine practices (N = 2). PARTICIPANTS: Two hundred fifty-four women 40 to 85 years of age. RESULTS: The mean lifetime and 5-year calculated breast cancer risk was 8.4% (SD [standard deviation] 6.1) and 1.5% (SD 1.3), respectively. Subjects had a mean estimation error for lifetime and 5-year risk of 29.5% (SD 22.9) and 24.8% (SD 23.9), respectively. In multivariate analyses, lower numeracy scores (0.005), higher number of previous breast biopsies (0.016), and a higher number of first-degree relatives (0.054) were predictive of larger estimation error for lifetime breast cancer risk. White race (0.014), lower educational levels (0.009), higher number of previous breast biopsies (0.008), and higher number of first-degree relatives (0.014) were predictive of larger estimation error for 5-year risk. CONCLUSION: Among a primary care population, breast cancer risk factors may be more consistently associated with pessimistic perceptions of breast cancer risk than other factors studied during a lifetime and 5-year time span. Primary care physicians should consider counseling patients about individual breast cancer risk factors and risk over time.

Adult↗
PubMed2003

[Factors associated with HIV risk perception among hospital postpartum women].

OBJECTIVE: To assess factors associated with perception of HIV infection risk among postpartum women admitted to charitable maternity hospitals. METHODS: The study sample comprised 384 postpartum women admitted to two charitable maternity hospitals in the city of São Paulo, Brazil. Data collection was carried out from January to March 2000. All women were interviewed 12 hours after delivery and data was collected on sociodemographics, STD/AIDS knowledge and attitudes (independent variables) and cultural issues (dependent variables), and "whether she considered herself at risk for HIV infection" (dependent variable). Statistical analysis was performed using Chi-square test and multiple logistic regression. RESULTS: Nearly 29% of postpartum women considered themselves at risk for HIV infection. They were single, had prior STD and believed "married men enjoy himself in the same way as single men do". Prevention and health maintenance behaviors were also identified. CONCLUSIONS: Women's knowledge on AIDS seems to affect their individual risk perception. Future HIV/AIDS prevention campaigns should be focused on increasing couples and adolescents' involvement.

Adolescent↗
PubMed2005

Predictive genetic testing for Alzheimer's disease: impact upon risk perception.

UNLABELLED: The aim of this study was to determine the impact on risk perceptions of disclosing genetic test results used to estimate the risk of Alzheimer's disease (AD). Adult children (n = 149) of people with AD were randomized to one of two groups--Intervention group: lifetime risk estimates of AD based on age, gender, family history, and Apolipoprotein E (APOE) genotype; CONTROL GROUP: lifetime risk estimates of AD based on the same risk factors excluding APOE genotype. Perceptions of personal risk (PPR) for AD were assessed six weeks after risk assessments. PPR were correlated with actual lifetime risk estimates (r = 0.501; p < 0.0001). After controlling for lifetime risks communicated to participants, age, and number of affected relatives, PPR scores among those with an epsilon4-positive test result (the test result associated with increased AD susceptibility) (adjusted mean: 3.4 (SD: 0.7)) were not different from the PPR scores in the CONTROL GROUP (adjusted mean: 3.4 (SD: 0.7) (F1,91= 1.98; p = 0.162). Again, controlling for lifetime risk estimates, age, and number of affected relatives, the PPR score of those receiving an epsilon4-negative test result was significantly lower (adjusted mean: 3.1 (SD: 0.8)) than those in the CONTROL GROUP (adjusted mean: 3.4 (SD: 0.7) (F1,95 = 6.23; p = 0.014). Perceptions of risk of developing AD are influenced by genetic test disclosure in those receiving epsilon4-negative, but not those receiving epsilon4-positive test results. Despite the reduced perceptions of risk in the former group, there was no evidence of false reassurance (i.e., perceiving risks as equal to or lower than population risks of AD), although this possibility should be assessed in other testing contexts.

Age Factors↗
PubMedDate not supplied

Young adult smoker risk perceptions of traditional cigarettes and nontraditional tobacco products.

OBJECTIVE: To explore risk perceptions of traditional and nontraditional tobacco products (NTPs) among young adult smokers. METHODS: Focus groups with African Americans, non-Hispanic whites, and Hispanics. Risk ratings of light, regular, and menthol cigarettes and of NTPs and marijuana and cigarettes were compared. RESULTS: Participants tended to view light cigarettes as safer than regular cigarettes. Shisha and herbal products were rated as safer than traditional cigarettes, but there were differences in ratings by race/ethnicity, related to preferred cigarette variety. CONCLUSIONS: Health communication messages about the use of cigarettes and NTPs should consider risk perceptions about the products and racial/ethnic differences.

Adult↗
PubMedDate not supplied

Risk perception differences in a community with a municipal solid waste incinerator.

Using a community model of risk perception, we conducted an environmental risk perception survey in a community with an operating municipal solid waste incinerator to further understanding of community responses to technology perceived as "hazardous". The specific aims of the survey were to study attitudes to waste management (incineration in particular) and to identify sociological attributes which help shape community attitudes to the facility. Approximately one third of the community were unaware of the incinerator. Those unaware gave lower desirability ratings to incinerator technology than the aware group. About half of the aware group were concerned about the facility and rated the incinerator in the same way as those who were unaware; however, the remainder (the unconcerned) appear to have accepted the incinerator. The results of this cross-sectional study suggest that informing the public about technology perceived as hazardous may not lead to alarm, but may in fact increase acceptance.

Attitude to Health↗
PubMed1995

The impact of Magic Johnson's HIV serostatus disclosure on unmarried college students' HIV knowledge, attitudes, risk perception, and sexual behavior.

Unmarried heterosexual college students' HIV knowledge, attitudes, risk perception, and sexual behavior were assessed before and after "Magic" Johnson revealed his HIV-positive serostatus. Students examined after the disclosure showed a small, though statistically significant, increase in scores on HIV knowledge. Analyses did not reveal any other differences between the pre- and postdisclosure samples. Several differences between men's and women's scores were found, however. In addition, participants in both groups demonstrated generally positive attitudes toward HIV and people with HIV disease; rated their risk of future HIV infection as none to minimal; and reported frequently engaging in vaginal, oral, and anal intercourse without the use of condoms. These results suggest that Magic's disclosure did not significantly affect these students' attitudes, risk perception, or sexual behavior and that such students continue to engage in behaviors that may put them at risk for HIV infection.

Adolescent↗
PubMedDate not supplied

Measuring risk perception among low-income minority primary care patients.

Studying patients' risk perceptions by ascertaining the probabilities of developing a disease is suboptimal, as patients might have difficulty using numerical expressions to depict the probabilities/chances of developing a disease. We surveyed patients at 2 community health centers and assessed risk perception by patients' self-reported chance of developing a disease (expressed in percentages), patients' relative chance of developing a disease compared to others' chance of developing a disease, and patients' ranked chances of developing different diseases. Many patients had difficulties understanding percentages and most patients overestimated their absolute risk. However, most patients indicated that they had a lower chance of developing diseases when compared to others. Patients with known risk factors (smoking) indicated a higher relative risk of developing an associated disease (lung cancer). Patients' ranked chances of developing different diseases were consistent with the actual frequency of developing a disease. Although patients had difficulty expressing risk in percentages, they estimated their risks well through comparisons with others and by ranking of disease frequencies.

Adolescent↗
PubMed2003

Heart disease risk perception in college men and women.

The authors sought to assess the perception of risks for coronary heart disease (CHD) in college men and women. They surveyed 470 undergraduates from 2 major 4-year institutions who completed a questionnaire that measured perceived risks for heart disease. Sixty-eight percent of the respondents rated their risks as lower or much lower than those of their peers, indicating a clear optimistic bias. The research also revealed that the students who exercised regularly rated their risk of coronary disease lower than those who did not do so. In addition, women perceived a number of risk markers to be more potent or causative factors than men did. A significant number of participants did not comprehend commonly understood causal relationships associated with heart disease risk. The findings in this preliminary investigation suggest that college men and women do not accurately perceive their risks for developing heart disease.

Adolescent↗
PubMed2000

Smoking among emergency chest pain patients: motivation to quit, risk perception and physician intervention.

The feasibility of the emergency department (ED) as a setting for smoking interventions was examined among 159 adult patients presenting with chest pain (38% were smokers). Subjects had been admitted to a 24-h observation unit (OU) to rule out myocardial infarction. We examined the frequency and extent of physician interventions for smoking using the AHCPR guidelines as a model. We also assessed patients' perceptions of risk from smoking and motivation to quit. Results indicate that ED physicians provided incomplete and inconsistent intervention. While most patients were asked if they smoked, only half were advised to quit, and few were offered assistance with quitting. Perceived risk from smoking was low among almost half of all smokers. However, over three-quarters were willing to receive smoking cessation counseling while in the ED. The ED may be an opportune setting in which to initiate smoking cessation counseling for certain high-risk populations.

Adult↗
PubMed1994

Risk perception by patients with anxiety disorders.

Studies by social psychologists have recently shown that normal people have systematically distorted perceptions of risk. We extend these studies to patients with anxiety disorders to see how they differ from normal subjects, and, more specifically, to test the hypothesis that anxiety disorders might result from excessively objective risk assessments. Fifty patients with anxiety disorders and 50 matched controls estimated the likelihood that 22 events would happen to the average person or to the self. On both measures, and on accuracy, the groups were essentially identical. In confirmation of previously reported patterns of risk distortion, both groups overestimated rare risks, underestimated common risks, and consistently underestimated the relative risks to self. These results suggest that cognitive estimates of specific risks are normal in patients with anxiety disorders.

Adult↗
PubMed2006

Risk perceptions, barriers, and motivators to tractor ROPS retrofitting in the New York state farm community.

The prevalence of tractor rollovers among agricultural workers has made the retrofitting of tractors with rollover protective structures (ROPS) and seat belts a public health priority for agricultural health and safety specialists. To address this concern, the New York Center for Agricultural Medicine and Health (NYCAMH) developed a seven-question survey, designed to assess perceptions of risk as well as potential motivators and barriers to retrofitting. Data from 465 phone surveys were gathered from New York State farmers representing various commodities and farm sizes. Analysis of responses to three qualitative questions contained in the survey indicated that most farmers in New York understand the importance of ROPS but lack the proper motivation to consider retrofitting. It appears that more convenient safety strategies, cost, and age of the tractor compete with a farmer's initiative to retrofit. In addition, survey responses illustrate that although many farmers believe ROPS are important in a general sense, many believe that this safety measure is not necessary for them in particular. Frequent motivators to retrofitting are concerns about safety, although the authors conclude that a more thorough analysis of these "general safety concerns" in qualitative interviews is important.

Accident Prevention↗
PubMed2003

Change in health risk perception following community intervention in Central Havana, Cuba.

It is increasingly recognized that individual values, beliefs and behavior operate within a social context. There is growing consensus that local perceptions and indigenous knowledge should be important elements in the evaluation of programs aimed at improving health. Thus, an assessment of changes in health risk perception was included in the evaluation of a multi-component intervention project undertaken between 1996 and 1999 aimed at improving the health and well-being of residents in the inner city community of Cayo Hueso, in Centro Habana, Cuba. The community intervention involved a tremendous mobilization of government and non-governmental organizations, to promote social and cultural activities and address deficiencies in housing, water supply, waste disposal and street illumination. Prior to the interventions, 365 adults were surveyed regarding their perceived health risks regarding 41 health determinants, scored on four-point Likert scales ranging from 'without risk' to 'very risky'. A factor analysis of these data classified perception of risk into five areas: social environment, threats to personal health, lifestyle choices, environmental sanitation and housing conditions. The objective of the current analysis was to determine if there were changes in the level of perceived risk to health over the 5 years pre- versus post-intervention in Cayo Hueso, and if so, whether these changes were significantly different from changes seen during the same 5-year period in Colón, another community in Centro Habana not receiving focused interventions. During the first quarter of 2001, 1703 individuals living in 654 households in Cayo Hueso and Colón were interviewed in their homes using an enhanced version of the 1996 risk perception instrument. Ordinal logistic regression models, adjusted for age, gender and years of education, were fit to assess change in health risk perception between 1996 and 2001. Significant declines in perceived health risk were found in both Cayo Hueso and Colón within all five domains, with significantly greater declines in many areas in Cayo Hueso compared with Colón, particularly with respect to housing-related health risks, indeed the main target of the intervention. Risk perception surveys are useful characterizations of widely held views in a target population. Our findings of decreased perceived health risk following public health, physical and social interventions to improve health suggests that this line of inquiry merits consideration in planning evaluations of multi-sectoral community-based health promotion interventions.

Adult↗
PubMed2005

Parental risk perceptions of childhood pedestrian road safety: a cross cultural comparison.

INTRODUCTION: This cross-sectional community-based randomized telephone survey, aimed to compare the parental risk perceptions on childhood pedestrian road safety among three different major community language speaking groups and the mainstream English speaking Australians in Sydney, Australia. METHOD: This was a community-based telephone survey with subjects randomly selected from the population of specific cultural languages in Sydney. RESULTS: Results indicated that Chinese and Arabic speaking parents or caregivers perceived the road environments as significantly less hazardous for their 4-12 year old children as pedestrians when compared with Vietnamese and English speaking parents. This was true even after adjusting for the age of child, socioeconomic status, and the living environments of respondents. CONCLUSION: The implication of the results was discussed in light of possible application to childhood safety behavior across different cultures. IMPACT TO THE INDUSTRY: The results obtained have highlighted the importance of cultural factors in risk perceptions, and safety behaviors. Cultural differences in risk perceptions should be taken into consideration in the design of safety education programs.

Accidents, Traffic↗
PubMedDate not supplied

Risk perception and communication regarding pesticide use in rural work: a case study in Rio de Janeiro State, Brazil.

In an agricultural region of Rio de Janeiro State, Brazil, rapid assessment procedures were used for risk-perception studies based on methodologic triangulation that included semi-structured interviews, participatory observations, and focus groups. Data were qualitatively categorized. Women's risk perception was prioritized, as they did not recognize some risks they were exposed to during work activities. To reach women likely to be exposed to pesticides, a photographic soap opera (fotonovela) was constructed in collaboration with rural workers, using community-based participatory research methods. Contents of the risk-communication strategies included the harmful effects of pesticides. Results showed that the inclusion of risk-perception studies in the development of educative and risk-communication campaigns is very important, bridging research to action.

Brazil↗