Risk Communication Programs Research Articles

Consumer knowledge, attitudes, and behaviour regarding food safety – A perspective from Laos

Primary research data on food chain safety at consumer level is needed to help policymakers to decrease the risk of foodborne infections in the Lao People's Democratic Republic. Therefore, the objectives of this study are to 1) determine Lao people's food safety knowledge, attitudes, and intentions and identify the most influential factors that shape their food safety behaviour, and 2) to support the government in the development of more efficient risk communication programmes. A paper-based consumer survey was implemented to collect quantitative data on the selected topics about Laotian consumers, as well as on the equipment of households regarding the conditions and tools necessary for safe food preparation and storage. A model was developed based on the extended Theory of Planned Behaviour (TPB), and partial least squares structural equation modelling (PLS-SEM) was applied to analyse the factors that affect food safety behaviour. The elements of Knowledge and Perceived Behavioural Control positively influence behaviours, such as using separate chopping boards for raw and ready-to-eat foods. According to the model, only 10 % of the Intentions would be translated into Behaviours, which gap can be explained by the lack of a hygienic environment. Although the survey indicated that Laotian people intend to follow food safety guidelines, participants felt they lacked sufficient knowledge. This perception was validated by the knowledge test and behavioural part of the study. In the light of these findings, it is essential to raise awareness and promote food safety knowledge and interventions, such as enhancing food safety education in childhood. This would help to facilitate and encourage adopting safe practices to improve overall food safety at the consumer level, delivering positive impacts also to the food business sector.

Impact of Covid -19 incidence rate and government-initiated risk communication measures on individual's NPI practices.

Non-pharmaceutical interventions (NPI) are the most widely recognized public health measures recognized globally to prevent the spread of Covid-19. NPIs' effectiveness may depend on the type, combination of applied interventions, and the level of proper public compliance with the NPIs. The expected outcome of behavioural practices varies relative to the intervention duration. This study aimed to assess the trend of community compliance to NPI with Covid-19 incidence and government-initiated interventions, and its variation by residence and sociodemographic characteristics of people. A weekly non-participatory field survey on individuals' NPI practices was observed from the 41st epidemiological week of October 5th, 2020, to the 26th epidemiological week of July 4th, 2021, a total of 39 weeks. The survey covered all 14 regional and national capital cities in Ethiopia. Data collection for the three NPI behaviours (i.e., respiratory hygiene, hand hygiene, and physical distance) was managed weekly at eight public service locations using the Open Data Kit (ODK) tool. The Covid- 19 incidence data and public health measures information from August 3rd, 2020 to July 4th, 2021 were obtained from the Ethiopian Public Health Institute (EPHI). More than 180,000 individuals were observed for their NPI practice, with an average of 5,000 observations in a week. About 43% of the observations were made in Addis Ababa, 56% were male and 75% were middle age group (18-50 years). The overall level of NPI compliance was high at the beginning of the observation then peaked around the 13th- 15th epidemiological weeks then declined during the rest of the weeks. The peak NPI compliance periods followed the high Covid-19 death incidence and government-initiated intensive public health measures weeks. Respiratory hygiene had the highest compliance above 41% whereas hand hygiene was the lowest (4%). There was a significant difference between residents of the capital city and regional cities in their level of compliance with NPI. Females comply more than males, and individuals had increased NPI compliance at the bank service and workplaces compared to those in the transport services at P = 0.000. An increased level of compliance with NPI was observed following intensive government-initiated Covid-19 prevention measures and an increased Covid-19 death incidence. Therefore, the intensity of government-initiated risk communication and public advocacy programs should be strengthened, possibly for similar respiratory disease pandemics in the future.

Development of the capacity to communicate risks related to childhood exposure to fluorides through an online educational strategy

Fluorides are contaminants that occur frequently and, generally, naturally in groundwater, affecting countries that depend on these waters for irrigation and human consumption. Chronic exposure to fluorides generates various health effects; therefore, this research was based on education and risk communication to contribute to the resolution of the problem of fluoride exposure in the population. The objective was to develop the capacity to design risk communication programs for personnel involved in the response and management of environmental health risks, with emphasis on fluoride exposure. An online pilot training course on risk communication and fluoride exposure was designed and implemented. For the analysis of the risk perception and knowledge of the participants, before and after the course, a questionnaire was applied and a focus group was conducted. In addition, the participants carried out a series of activities and designed a risk communication program to assess the degree to which the capacity to develop risk communication programs was achieved. To improve the pilot course, two satisfaction surveys were designed and implemented, and a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis was conducted. The results showed an increase in the level of knowledge and changes in the participants' perception; regarding the ability to design risk communication programs, two participants were able to design them excellently. Previous experience, motivation, commitment to learn and the feedback provided during the course influenced the development of this ability.

Navigating the Aftermath: The Complex Landscape of COVID-19 in Northwest Syria

In the aftermath of the global upheaval caused by the COVID-19 pandemic, a nuanced perspective emerges, underscoring the need for vigilant and strategic healthcare responses. This article delves into the intricate landscape of COVID-19 within northwest Syria, highlighting the enduring challenges and the imperative for astute resource allocation, sustained vaccination efforts, and effective Risk Communication and Community Engagement programs. Situated within a region characterized by historical complexities and ongoing conflict, Northwest Syria remains a microcosm of persistent healthcare challenges. While the pandemic classification may shift, its lingering impact necessitates ongoing vigilance. This article explores the multifaceted dimensions of the prevailing COVID-19 scenario in Northwest Syria, emphasizing the crucial role of resource allocation, vaccination strategies, and Risk Communication and Community Engagement programs in forging resilient health systems. The imperative of vaccination, coupled with the formidable challenge of hesitancy, underscores the need for targeted and adaptable Risk Communication and Community Engagement initiatives. Drawing lessons from past shortcomings, Northwest Syria is poised to recalibrate its approach, fostering a blueprint for future crises that is attuned to community sentiments and responsive to evolving challenges. As Northwest Syria navigates the path to recovery, a comprehensive and adaptive response strategy anchored in effective Risk Communication and Community Engagement programs becomes a linchpin, guiding the region towards fortified health systems and improved public health conditions.

Community engagement and adherence to COVID-19 prevention measures in Northwest Syria: a systematic review

ABSTRACT The COVID-19 pandemic has increased the burden on the collapsing health system in northwest Syria. The situation was exacerbated by the low rates of adherence to preventive measures and acceptance of the COVID-19 vaccine. In this study, we systematically analysed studies related to Risk Communication and Community Engagement programs, and community awareness in northwest Syria in order to determine the most widespread prevention methods, the community’s perspectives and knowledge of epidemic prevention, and the factors that prevent effective community engagement and uptake of COVID-19 prevention precautions in an area that has been suffering from the scourge of conflict for more than ten years. Based on the research findings, low adherence to COVID-19 prevention measures is mainly due to external factors related to socioeconomic status, scarcity of resources, and poor living conditions. Therefore, this study suggested that integrated multi-sectoral humanitarian programs that address these factors holistically are more effective than solely public health interventions in involving the community to become an active part of the Risk Communication and Community Engagement programs and ensuring their effectiveness.

Risk communication regarding radiation exposure by experts using two concepts of regulatory science and ALARA

In the Tohoku region of Japan, risk communication programs on radiation exposure are of great importance, especially with respect to reducing the stress and anxiety among those affected by radiation exposure. Although the concepts of ‘as low as reasonably achievable’ (ALARA) and regulatory sciences (RS) were very important for the smooth operation of risk communication among a wide range of stakeholders, our previous research showed that only 23.5% and 16.5% of medical doctors in Japan had an accurate awareness of them, respectively. To make risk communication more effective, this study examined the levels of awareness of the concepts of ALARA and RS among academic experts in Japan and compared their level of awareness of technical terms regarding radiation to that of the expected level for a layperson. This study also showed that, even among faculty working at graduate schools in Japan, only 29.8% and 39.4% had an accurate knowledge of ALARA and RS. To improve the knowledge of laypeople and experts on these concepts, they should be added to the primary education curriculum. This study demonstrated that among experts in many academic fields, a significant range of estimates existed of lay knowledge of technical terms regarding radiation. The highest scores were assigned by faculty in the field of humanities. Thus, before conducting risk communications, experts from all fields should identify the expected level of awareness among laypeople on the topic. In addition, risk communications regarding radiation should be conducted by academic experts and healthcare professionals together with facilitators or lecturers.

Indian Adults and Covid-19 Scenario

In order to understand the knowledge and practices used by the selected respondents in adopting a new normal to resist the COVID-19 pandemic age, the current study, titled Knowledge and Practices towards COVID-19 of the People of Ahmedabad City of Gujarat State, was conducted. 200 respondents from Ahmedabad City, aged 21 to 58, were chosen using a convenient sampling method. An online questionnaire using Google Forms was designed and executed using different social platforms such as email, WhatsApp, and text messages. In the study, descriptive statistics such as mean and standard deviation for continuous variables and frequency and percentages for discrete variables were used. Results of this study showed that social media was the most commonly accessed source of information on COVID-19 and that a large majority of respondents had greater access to information about it. Further, the majority of the respondents had a higher level of knowledge and were well-informed on the signs and symptoms, the spread of the disease, and preventive measures, but they were only partially or incorrectly informed about the recommended hand hygiene practices and risk factors that could increase the virus’s ability to spread. Nevertheless, more than half (54%) of the responders had inadequate COVID-19 practices. With regard to the variables of education and occupation, there were significant disparities in the respondents’ practices. The results of this study could serve as a baseline for NGOs, government officials, and other stakeholders as they reform and rebuild risk communication programs for such highly contagious diseases.

Psychometric properties of the Chinese version of Attitudes and Beliefs about Cardiovascular Disease Risk Perception Questionnaire

Cardiovascular disease (CVD) is the leading cause of global mortality and disease burden. The perceived risk of CVD, a central psychological construct, may affect health behavior change and maintenance, such as lifestyle modification and medication adherence. Risk perception varies based on the knowledge of risk in the context of cultural health-world views. Little is known about CVD-related knowledge and risk perception in China. The aim of this study is to cross-culturally translate, adapt, and evaluate the psychometric properties of the Attitudes and Beliefs about Cardiovascular Disease (ABCD) Risk Perception Questionnaire in Chinese. The translation and cross-cultural adaptation process followed established guidelines. A cross-sectional study of 318 adults between April and May 2022 was conducted in Zhejiang province. The study evaluated the item- and scale-level psychometric properties and validity indices of the ABCD risk perception questionnaire. The exploratory and confirmatory factor analyses of the risk scale supported a three-factor solution that accounts for 69.63% of the total variance, corresponding to risk perception (F1), perceived benefits and intention to change physical activity (F2), and perceived benefits and intention to change dietary habits (F3). Adequate content validity (I-CVI = 0.852–1.00, S-CVI = 946) was ensured by expert panel. The internal consistency of the dimensions showed good results ranging from 0.801 to 0.940 for Cronbach's α, and 0.853 to 0.952 for McDonald’s ω. The item analysis of knowledge dimension indicated that the item difficulty index was 0.440 to 0.852, the item discrimination index was 0.572 to 0.707. This study confirmed that the Chinese version of the ABCD risk perception questionnaire has good psychometric properties in terms of measuring CVD-related knowledge and risk perception in the Chinese adult population, which can lead to the development of individually tailored CVD-risk reduction intervention programs or risk communication programs by health providers.

Postmenopausal overweight and breast cancer risk; results from the KARMA cohort

PurposeTo study the risk of incident breast cancer and subtype-specific breast cancer in relation to excess body weight in a contemporary Swedish prospective cohort study, The Karolinska Mammography Project for Risk Prediction of Breast Cancer, KARMA.MethodsA total of 35,412 postmenopausal women attending mammography and included in the KARMA study provided baseline data on body mass index (BMI) and potential confounders. During eight years of follow-up, 822 incident invasive breast cancer cases were identified.ResultsWomen with overweight (BMI ≥ 25–< 30 kg/m2) constituting 34% of the study cohort had an increased risk of incident breast cancer with an adjusted Hazard Ratio (HRadj) 1.19 (95% CI 1.01–1.4). A similar, however, non-significant, association was found for women with obesity (BMI ≥ 30 kg/m2) conferring 13% of the cohort, with a HRadj of 1.19 (95% CI 0.94–1.5). Overweight was associated with risk of node-negative disease (HRadj 1.29, 95% CI 1.06–1.58), whereas obesity was associated with node-positive disease (HRadj 1.64, 95% CI 1.09–2.48). Both overweight and obesity were associated with risk of estrogen receptor positive (ER+) disease (HRadj 1.20, 95% CI 1.00–1.44 and HRadj 1.33, 95% CI 1.03–1.71, respectively), and low-grade tumors (HRadj 1.25, 95% CI 1.02–1.54, and HRadj 1.40, 95% CI 1.05–1.86, respectively). Finally, obesity was associated with ER+HER2 negative disease (HRadj 1.37, 95% CI 1.05–1.78) and similarly luminal A tumors (HRadj 1.43, 95% CI 1.02–2.01).ConclusionOverweight and obesity are associated with an increased risk of developing breast cancer, specifically ER+, low-grade, and for obesity, node-positive, high-risk breast cancer indicating a further need for risk communication and preventive programs.

Service-Learning Experiences Related to Health Support Activities for Residents Who Have Returned Home after Evacuation Due to a Radiation Disaster.

Hirosaki University has regularly offered health support activities to residents of X town in Fukushima, and thus, some interactive benefits are expected as a service-learning experience for nursing students. This study aimed to clarify the experiences of students who participated in service-learning and consider which methods and content were effective. In total, 52 nursing students were recruited into the program, which was held from 2018 to 2021. The roles of students included assisting in health consultations related to a radiation disaster. Questionnaires designed by researchers with experience in risk communication programs were conducted on the students after the program, and included the reasons why they joined, their most memorable experiences, and their opinions regarding required support for residents. The data were analyzed by content analysis. The nursing students thought about the health of residents through health support activities in the affected areas. Furthermore, by communicating with residents via on-site service-learning, they could experience the humanity of the residents and the current status of the affected areas, learn the importance of person-to-person relationships, and think about reconstruction. Thus, service-learning was found to be effective and to offer substantial benefits for both residents and students in affected areas.

Public Search Interests Related to COVID-19: Insights from Google Search Trends in Bangladesh

PurposePublic response monitoring is critical to reducing COVID-19 infections and developing effective public health strategies. This study explored Google search trends to understand public responses to COVID-19 concerns in Bangladesh.Methods & MaterialsWe used country-level Google search trends data to examine the association between Google search terms related to COVID-19 deaths, face masks, and COVID-19 vaccines and the actual and one-week lagged actual COVID-19 death counts from February 2, 2020, to December 19, 2020, in Bangladesh.ResultsSearch terms related to COVID-19 deaths, face masks, and COVID-19 vaccines increased and peaked during March and April, but then began declining gradually after June 2020. The mean relative search volume for face masks (35 points) was higher than for death information (8 points) and vaccines (16 points) throughout the study period, and searching for masks peaked (100 points) during the third week of March. Search interests for death information and face masks were negatively correlated with the actual and one-week lagged actual COVID-19 death counts.ConclusionIn response to declining trends in COVID-19-related google search terms, policymakers should strengthen ongoing risk communication and preventive information dissemination programs to control and prevent COVID-19 cases and deaths.

Perspectives from the field: Evaluation of a relational model of risk communication in the context of extreme weather

This perspectives piece examines efforts to enact a new approach to risk communication (referred to as the relational model of risk communication) in the field. The model involves empowering community residents to translate and spread knowledge concerning risks from extreme weather events. The process of implementing and evaluating the model by the Cyclone Preparedness Programme of Bangladesh is described. Of particular interest is the task of analyzing the program's effects in practice, which involved an ad hoc exercise in data collection and analysis. The study found that the enhanced mode of risk communication was indeed practiced in the field. Secondly, there was a marked improvement in evacuation behavior, which may partly be due to the risk communication program. The inquiry underscores both the potential and challenges of conducting field evaluation (whether after or during an event). The capacities for evaluation of field agents need to be fostered, as well as the construction of systematic data collection instruments for use in real-time.

Evaluation of a Risk Communication Program for Pesticide Residues

To promote and raise the awareness of accurate knowledge on pesticide residues, the symposium program on risk communication on pesticide residues was held by the broadcasted online style. The risk communication program was statistically evaluated using a pre- and post-program online questionnaire survey. We had the questionnaire answers of the 105 valid participants. The analysis of post-program questionnaires shows that the risk communication program was effective in terms of levels of understanding and interest. Pre-program risk perception or awareness of safety assessments was significantly and positively correlated with awareness for establishing standard values of pesticide residues by the analysis of pre-program questionnaires. Risk perception after the program was significantly higher than before the program, suggesting that risk perception increased due to the program by analysis the same question between pre- and post-program questionnaires. Multiple regression analysis suggests that the participants with higher pre-program awareness of safety assessments or pre-program awareness for establishing standard values appeared to have higher levels of understanding and post-program risk perception.

Users\u2019 perceptions about receiving personalized depression risk information: findings from a qualitative study

ObjectivesTo understand users’ perceptions about receiving their personalized depression risk score and to gain an understanding about how to improve the efficiency of risk communication from the user perspective.MethodsA qualitative study embedded in a randomized controlled trial (RCT) on evaluating the impact of providing personalized depression risk information on psychological harms and benefits. The participants (20 males and 20 females) were randomly selected from the intervention arm of the RCT after the 12-month assessment. The qualitative interviews were conducted through telephone, audio recorded and transcribed verbatim. We conducted a content analysis to describe the content and contextual meaning of data collected from participants.ResultsThe first theme explained the motivation for receiving a risk score. Most participants chose to receive their personalised depression risk score with the goal of improving their self-awareness. The results revealed three sub-themes surrounding perceptions and implication of receiving their risk score: positive, negative, and neutral. Most participants found that receiving their score was positive because it improved their awareness of their mental health, but some participants could see that some people would have negative feelings when getting the score causing them to be more likely to get depression. The final theme focussed on improvements including: the best delivery methods, having resources and strategies, and targeting younger people.ConclusionThe most significant motivation for, and benefit of receiving one’s personalized depression risk score was improved awareness of one’s mental health. A comprehensive risk communication program may improve the uptake and maximize the impact on behavior changes and risk reduction.

Risk Communication Through Health Beliefs for Preventing Opisthorchiasis-Linked Cholangiocarcinoma: A Community- Based Intervention in Multicultural Areas of Thailand.

Objective:This research aimed to study the effects of the risk communication program through the Cambodian folk song to prevent Opisthorchiasis-linked cholangiocarcinoma (OV-CCA). Methods:We conducted the quasi-experimental research between August and December 2017 in the Cambodian communities, one-fourth of ethnic minorities residing in multicultural areas of Sisaket Province, Thailand. The samples consisted of 94 equally people divided into experimental group and control group. The experimental group included 47 people at-risk of OV-CCA who received the program for 12 weeks, while the control group received regular services. We collected data by using a questionnaire with a reliability of 0.93. Descriptive and inferential statistics were used for data analysis. Results:The study indicated that the socioeconomic information of both groups was not different. The mean scores of all issues (health beliefs, social support, and prevention behavior in the experimental group were higher than those of the control group with statistical significance. Closer inspection showed that the mean difference of the health beliefs was 55.61 points (95%CI: 52.39-57.42, p<0.001), social support was 9.09 points (95%CI: 8.12-10.05, p<0.001), and prevention behavior was 6.38 points (95%CI: 5.43-7.33, p<0.001). Conclusion:Through the Cambodian folk song, the risk communication program by applying the health beliefs and social support to prevent OV-CCA is beneficial for behavior modification in areas with similar cultures.

Regionally representative hair mercury levels in Canadian First Nations adults living on reserves

ObjectiveThe primary objective of this participatory study was to assess the current body burden of mercury among First Nations adults.MethodsThe First Nations Food, Nutrition and Environment Study (2008–2018) collected regionally representative data from First Nations adults living on reserves south of the 60th parallel. Mercury was analyzed in hair as a preferred biomarker for prolonged exposure. Hair samples, a 5 mm bundle cut from the occipital region, were collected from the participants who gave consent and measured for total mercury concentrations using cold vapor atomic fluorescence spectrophotometry.ResultsIn total, 3404 First Nations adults living in 92 communities provided hair samples. This represents 52.5% of the respondents to the household surveys. The mean hair mercury concentrations were 0.56 μg/g among all participants and 0.34 μg/g among women of childbearing age (WCBA). There were 64 exceedances of Health Canada’s mercury biomonitoring guidelines (44 WCBA, 8 women aged 51+ years, 3 men aged 19–50 years, and 9 men aged 51+ years).ConclusionCurrent mercury exposure no longer presents a significant clinical health risk in most of the First Nations population south of the 60th parallel across Canada. However, mercury exposure continues to be an ongoing environmental public health concern that requires continued monitoring and assessment. Women of childbearing age (19–50 years) and older individuals living in northern ecozones and Quebec have higher mercury exposures, often exceeding Health Canada’s guidelines. Careful risk communication and risk management programs need to focus on northern ecozones and Quebec.

Developing and Implementing a Patient Behaviour Risk Screening, Communication and Care Planning Intervention for Hospital Settings.

Workplace violence prevention of patient behaviours is a primary safety focus in hospital settings. In response to provincial mandates, a multi-site tertiary care hospital system developed the Behaviour Safety Risk Communication and Care Planning Program. Components include patient risk screening, communication tools and care plans that outline mitigation strategies. The program has been implemented at six sites using the following strategies: educational and planning meetings, formation of steering committees, identification of champions, educational materials/training, facilitation and consultation, and audit and feedback. Our paper can guide program development and implementation in similar contexts.

Medical staff perceptions of risk communication needs for the public and comparison with the needs expressed by the public

Risk communication programs about radiation exposure should be conducted continuously and rigorously by healthcare workers in the Tohoku region in order to reduce the stress caused by radiation exposure. This study aimed to compare the perception by medical staff of the public need to the public need as defined in a previous study, as well as examine the level of perception among healthcare workers of the two concepts “as low as reasonably achievable” (ALARA), and Regulatory Sciences. These two concepts were expected to be the ones to impart information regarding the effect of radiation on the human body during risk communication. The results showed differences between the public perception of risks and belief of what the public risk perception was by the medical staff. In addition, only 23.5% and 16.5% medical doctors had accurate perception of ALARA and Regulatory Sciences in Japan, respectively, even after the great East Japan Earthquake., ALARA and Regulatory Sciences should be added to healthcare workers’ education curriculums to enhance their knowledge level of these concepts. From the viewpoint of laypersons, public health awareness programs conducted by the local and central governments ranked fourth and fifth respectively as sources of information. One of the reasons was that, to some extent, the attitude of the central government seemed apt to be overbearing to laypersons. Therefore, we also believe that medical doctors are expected to be intermediaries between central/local governments and laypersons.

Epidemiological investigation of feline infectious peritonitis in cats living in Harbin, Northeast China from 2017 to 2019 using a combination of an EvaGreen-based real-time RT-PCR and serum chemistry assays

Feline infectious peritonitis (FIP) is caused by the FIP virus (FIPV), a highly virulent mutant form of feline coronavirus (FCoV). This disease is one of the most important infectious diseases in cats, and it is associated with high mortality, particularly among younger cats. In this study, we isolated a wild-type FIPV HRB-17 epidemic strain from the blood sample of household pet cat exhibiting the characteristic wet-form FIP symptoms, which has been confirmed further by animal infection. Further, we developed an EvaGreen-based real-time RT-PCR assay for the accurate detection of FCoV based on the amplification of the highly conserved FIPV N gene. Then, using a combination of the real-time RT-PCR approach and a serum chemistry assay, we performed an epidemiological survey of FIPV infection in cats living in Harbin City, Northeast China. The results indicated that the EvaGreen-based real-time RT-PCR assay can be used for screening FCoV infection in the affected cats at an analytical detection limit of 8.2 × 101 viral genome copies/μL, but could not effectively distinguish FIPVs from FECVs. Additionally, the results of the epidemiological survey investigating feline blood samples (n = 1523) collected between July 2017 to July 2019 revealed an FIPV prevalence of approximately 12% (189/1523). Maybe, the prevalence would be less than 12% due to the real-time RT-PCR assay could not accurately differentiate FIPV and FECV. Nevertheless, it still highlighted the severity of the FIP epidemic in cats and reiterated the urgent need to develop effective anti-FIP therapeutic agents and anti-FIPV vaccines. As pet cats are household animals, risk communication and continuous region-extended surveillance cat programs are recommended.

Risk estimation, anxiety, and breast cancer worry in women at risk for breast cancer: A single-arm trial of personalized risk communication.

Elevated anxiety and breast cancer worry can impede mammographic screening and early breast cancer detection. Genetic advances and risk models make personalized breast cancer risk assessment and communication feasible, but it is unknown whether such communication of risk affects anxiety and disease-specific worry. We studied the effect of a personalized breast cancer screening intervention on risk perception, anxiety, and breast cancer worry. Women with a normal mammogram but elevated risk for breast cancer (N = 122) enrolled in the Athena Breast Health risk communication program were surveyed before and after receiving a letter conveying their breast cancer risk and a breast health genetic counselor consultation. We compared breast cancer risk estimation, anxiety, and breast cancer worry before and after risk communication and evaluated the relationship of anxiety and breast cancer worry to risk estimation accuracy. Women substantially overestimated their lifetime breast cancer risk, and risk communication somewhat mitigated this overestimation (49% pre-intervention, 42% post-intervention, 13% Gail model risk estimate, P < .001). Both general anxiety and breast cancer worry declined significantly after risk communication in women with high baseline anxiety. Baseline anxiety and breast cancer worry were essentially unrelated to risk estimation accuracy, but risk communication increased alignment of worry with accuracy of risk assessment. Personalized communication about breast cancer risk was associated with modestly improved risk estimation accuracy in women with relatively low anxiety and less anxiety and breast cancer worry in women with higher anxiety. We detected no negative consequences of informing women about elevated breast cancer risk.