Improving cancer risk communication: a discussion of Fischhoff.

Abstract

Fischhoff’s recommendations are clear and extremely promising. Following his recommendations will not be easy, however, as they represent a considerable challenge to the field of risk communication. Fischhoff recommends a formal set of procedures for capturing and comparing expert conceptions (an “expert model”) and target audience conceptions (a “mental model”) of the risk at issue. After these conceptions have been formalized, an iterative research-based process is used to determine which elements of the expert model most effectively improve target audience understanding of the risk. Whereas the skills to conduct these procedures may be stock in trade for risk and decision scientists, they are unknown to the majority of health and risk communication planners. Accelerating the adoption of Fischhoff’s formalized approach will require a considerable investment in research and development (R&D) and training, although if made, the dividends are likely to be considerable. R&D is needed to create simple yet robust means for developing expert and mental models, as well as empirical procedures by which to determine which information from the expert model is most useful. Health and risk communication professionals, students, and the people who teach and advise them will require training, at a minimum, to understand the rationale underlying this formalized approach. Until such time that risk communication professionals have a full understanding of the process, risk or decision scientists or both should be integral members of the communication planning team. There are budgetary and timeline implications at the operational level as well. When properly conducted, communication planning requires an investment of time and money in audience or formative research. Fischhoff’s formalized approach to risk communication planning, however, may pose even greater time and financial demands, at least initially. These demands may be lessened in the long run as expert models and audience mental models become available in the published literature and elsewhere.