Uncovering public perceptions of scary contaminants and how and how not to communicate about them: a mixed-methods approach incorporating cognitive semantics

Abstract

BackgroundAlthough media reporting on health risks has a tendency to stir up worry, this worry is often misplaced when reports involve the misrepresentation of unsubstantiated scientific evidence. The presence of endocrine-disrupting compounds and pharmaceuticals and personal care products in the water supply has attracted substantial media attention, particularly in the USA, followed by intense policy discussions, despite the fact there is no concrete evidence to suggest a risk to public health. Working with a wide range of stakeholders including water utilities, public health officials, and consumer associations, we set out to explore the public's perspective on the health risks posed by contaminants, their science, and regulation to support the water industry in the development of fresh and effective communication. MethodsTo better assess public conceptualisations and measure public knowledge about contaminants in the UK and USA, we combined structured focus groups (11 groups of 12 participants), analysed by grounded theory, and a perceptions questionnaire (533 participants), analysed by regression analysis of a-priori hypotheses, with a range of tasks informed by cognitive semantics. These tasks include a quantitative and qualitative linguistic analysis of media and outreach texts (500 texts), several media text or report scenarios (embedded in focus groups and surveys), plus a free word association test incorporated into a language survey (two samples of 50 participants). The cognitive components were designed to investigate how members of the public reacted to and assessed these messages and the language and rhetorical techniques used to represent them. Ethics approval was granted by King's College London research ethics committee. Only adults were included in the study; all demographic data were compared with UK and US census data (appendix). FindingsReading media reports was more likely to predict worry about contaminants, with females compared with males (p=0·007) and those with long-term illness or disability compared with those without (p=0·018) more likely to worry. Despite a greater tendency to worry, neither group was more likely to search for information about contaminants (for both groups p>0·05). Additionally, some members of the public believed that tap water containing contaminants is still safe to drink, yet worry about it and filter it or avoid drinking it altogether. The cognitive instruments embedded in the methodology enabled the identification of words and notions that were used to communicate the risks, science, and regulation of contaminants that were responsible for causing worry. Although uncertainty and contamination as notions and the language associated with contaminants have very strong negative associations, regulations drew very strong positive associations, and thus the notion of unregulated contaminants proved the most worrisome of all. InterpretationUnnecessary worry about uncertain health risks on the basis of unsubstantiated evidence can lead to behaviour changes and can have wider implications for regulators and public health organisations. The language used in communication aimed at attenuation and reassurance needs to be tailored to consumer conceptualisations because some terms can evoke strong negative associations even if the message is positive. The project findings and recommendations are being directly fed into water industry communication policy and are being used to tailor communication to a wide range of consumer groups. FundingThe Water Research Foundation fully funded the study and appointed a project advisory committee.