Risk Communication Research Research Articles

Applying the Common Sense Model to Measure Representations of Arsenic Contaminated Well Water

Theory-based research is needed to understand how people respond to environmental health risk information. Both the common sense model (CSM) of self-regulation and the mental models approach propose that information shapes individuals' personal understandings that, in turn, influence their decisions and actions. We compare these frameworks and explain how the CSM was applied to describe and measure mental representations of arsenic contaminated well water. Educational information, key informant interviews, and environmental risk literature were used to develop survey items to measure dimensions of cognitive representations (identity, cause, timeline, consequences, control) and emotional representations. Surveys mailed to 1,067 private well users with moderate and elevated arsenic levels yielded an 84 % response rate (n = 897). Exploratory and confirmatory factor analyses of data from the elevated arsenic group identified a factor structure that retained the CSM representational structure and was consistent across moderate and elevated arsenic groups. The CSM has utility for describing and measuring representations of environmental health risks, thus supporting its application to environmental health risk communication research.

Researchers Update Risk-of-Death Charts

Researchers have now updated charts that show an American's risk of dying from a given cause over the next 10 years, based on age, gender, and smoking status. The charts appeared online June 10 in the Journal of the National Cancer Institute. To help physicians and patients assess an individual's risk of dying from 1 condition versus another, Lisa Schwartz, MD, of the Department of Veterans Affairs Medical Center in White River Junction, Vermont, and colleagues at Dartmouth University used the National Center for Health Statistics Multiple Cause of Death Public Use File for 2004 to generate charts that depict the risk of dying from a given cause within the next 10 years. To generate the updated charts, Schwartz et al modified their previous methodology by including former smokers as a separate category to better account for a person's smoking status. For all ages, men have a higher risk of death from all causes combined, relative to women. For both men and women, smoking increases the risk of death by nearly the same magnitude as adding 5–10 years to a person's age. For men who have never smoked, the risk of dying from heart disease at any age exceeds the risk of dying from lung, colon, and prostate cancer combined. For men who currently smoke, the risk of dying from lung cancer is greater than the risk of dying from heart disease after age 60, and it is 10-fold higher than the chance of dying from prostate and colon cancer combined. For women who have never smoked, the chances of dying from heart disease and breast cancer are similar until age 60, after which heart disease incurs a higher risk of death. For women who currently smoke, the chances of dying from lung cancer or heart disease are greater than the chance of dying from breast cancer after age 40. “The risk charts provide two basic elements that people need if they are to make sense of the health threats they face: the magnitude of the risk and some context,” the authors write. “We hope that the availability of these simple charts will facilitate physician–patient discussion about disease risk and help people understand where to focus risk reduction efforts.” The charts are posted electronically as 10 Supplementary Figures in a variety of formats (as presented in the paper, as separate charts for each smoking category, and as single-page charts presenting all the data in 1 place for men and women), the authors note. “We encourage physicians (and others) to post the charts in clinic offices or distribute them to patients for easy reference when decisions (such as cancer screening) are being made,” the authors write. In an accompanying editorial, Michael Thun, MD, of the American Cancer Society in Atlanta and colleagues discuss the value of these charts and ways that physicians can best utilize them. For example, just posting the charts in the waiting room of a physician's office may not be as effective as incorporating them into an interactive format of some kind. “The risk estimates provided by [Schwartz and colleagues] bring us a step closer to the goal of communicating effectively about risk in the context of routine medical care. The next steps could involve collaboration with other risk communication researchers to personalize this information and deliver it in ways that maximize its impact on health behaviors,” the editorial concludes. For further information, see “The Risk of Death by Age, Sex, and Smoking Status in the United States: Putting Health Risks in Context.” J Natl Cancer Inst June 10, 2008 (on-line edition).

Communicating With the Public About Emerging Health Threats: Lessons From the Pre-Event Message Development Project

We sought to better understand the challenges of communicating with the public about emerging health threats, particularly threats involving toxic chemicals, biological agents, and radioactive materials. At the request of the Centers for Disease Control and Prevention, we formed an interdisciplinary consortium of investigative teams from 4 schools of public health. Over 2 years, the investigative teams conducted 79 focus group interviews with 884 participants and individual cognitive response interviews with 129 respondents, for a total sample of 1013 individuals. The investigative teams systematically compared their results with other published research in public health, risk communication, and emergency preparedness. We found limited public understanding of emerging biological, chemical, and radioactive materials threats and of the differences between them; demand for concrete, accurate, and consistent information about actions needed for protection of self and family; active information seeking from media, local authorities, and selected national sources; and areas in which current emergency messaging can be improved. The public will respond to a threat situation by seeking protective information and taking self-protective action, underlining the critical role of effective communication in public health emergencies.

Making numbers matter: present and future research in risk communication.

To summarize existing research on individual numeracy and methods for presenting risk information to patients. We selectively retrieved articles from MEDLINE and the Social Sciences Citation Index. Many Americans have low numeracy skills, a deficit that impedes effective health care. Approaches to risk communication vary in current practice, but how risks are presented can significantly affect both patients' risk perceptions and their knowledge. Adhering to some basic principles for presenting risk information to patients can improve understanding. However, different risk-communication methods may be needed for individuals with high versus low levels of numeracy.

Making Numbers Matter: Present and Future Research in Risk Communication

Making Numbers Matter: Present and Future Research in Risk Communication

Preparing for natural hazards: the role of community trust

PurposeThis paper seeks to examine how perception of the relationship between people and sources of information influence hazard preparedness and how trust in civic emergency planning agencies responsible for risk communication influences preparedness decisions. It aims to hypothesize that: familiarity with and information about hazards predicts the relative importance of trust; and that levels of trust are influenced by community characteristics.Design/methodology/approachA cross‐sectional analysis of the relationship between trust and hazard preparedness was conducted. Hypotheses were tested using data on bushfire, volcanic and earthquake hazards. Data were analysed using multiple regression analyses.FindingsThe first hypothesis, that situational factors predict the relative importance of trust, was supported. Partial support was forthcoming for the second hypothesis. Collective problem solving and empowerment predicted levels of trust.Research limitations/implicationsThe findings demonstrated the utility of this multi‐level model for the analysis of risk communication and need to accommodate societal‐level variables in future risk communication research. The source of information plays a role in risk communication that is independent of the information per se.Practical implicationsThe relationship between people and civic agencies and the information provided must be accommodated in planning risk communication. The analysis provides an evidence‐based framework for the development of risk communication strategies based on community engagement principles.Originality/valueThis is the first time this multi‐level model has been applied to natural hazards and contributes to understanding the contingent nature of the risk communication process.

Strategic risk communication: Adding value to society

The purpose of this paper is to provide a concise summary of the evolvement and the current state of risk communication research and draw insights from a decade of risk communication studies [Heath, R. L., & Abel, D. D. (1996). Proactive response to citizen risk concerns: Increasing citizens’ knowledge of emergency response practices. Journal of Public Relations Research, 8(3), 151–171; Heath, R. L., & Palenchar, M. (2000). Community relations and risk communication: A longitudinal study of the impact of emergency response messages. Journal of Public Relations Research, 12(2), 131–162; Palenchar, M. J., & Heath, R. L. (2002). Another part of the risk communication model: Analysis of communication processes and message content. Journal of Public Relations Research, 14(2), 127–158; Palenchar, M. J., & Heath, R. L. (2003a). Protracted strategic risk communication: A longitudinal analysis of community's zones of meaning. Paper presented at the conference of the Association for Education in Journalism and Mass Communication, Kansas City, MO; Palenchar, M. J., & Heath, R. L. (2003b). Strategic risk communication: A longitudinal analysis of a community's emergency response awareness and practices. Paper presented at the conference of the National Communication Association, Miami, FL; Palenchar, M. J., & Heath, R. L. (2006). Strategic risk communication campaigns: Some insights from the culmination of a decade of research. Paper presented at the conference of the International Communication Association, Dresden, Germany; Palenchar, M. J., Heath, R. L., & Dunn, E. (2005). Terrorism and industrial chemical production: A new era of risk communication. Communication Research Reports, 22(1), 59–67]. A meta-analysis of the authors’ research based on qualitative and quantitative research methodologies, including professionally conducted telephone interviews, focus groups, in-depth interviews and ethnography, suggests that strategic risk communication based on the concept that ideas and meaning count, transparency, building trust through community outreach and collaborative decision making, acknowledging uncertainty, and narrative enactment are fundamental communication guidelines for good organizations communicating well; keys for risk communication if it is to add value to society.

False Alarms, Real Challenges—One University's Communication Response to the 2001 Anthrax Crisis

Considerable research exists on how government agencies at the federal, state, and local levels communicated during the fall 2001 anthrax attacks. However, there is little research on how other institutions handled this crisis, in terms of their response to potential anthrax contamination (aka "white powder scares") and their approach to disseminating important health and safety information. In this article, we investigate a major university's communication response to the anthrax crisis. First, we describe its communication experiences relating to a large white powder scare that occurred in October 2001. Second, we describe the university's broader communication efforts in terms of several important elements of risk communication research, including influence of source attributes, key messages, preferred channels, responses to information requests, and organizational influences. This study underlines that an institution does not have to be directly affected by a crisis to find itself on the communication "front lines." Moreover, other institutions may find it useful to learn from the experiences of this university, so that they may communicate more effectively during future crises.

Defining Moments in Risk Communication Research: 1996–2005

Ten years ago, scholars suggested that risk communication was embarking on a new phase that would give increased attention to the social contexts that surround and encroach on public responses to risk information. A decade later, many researchers have answered the call, with several defining studies examining the social and psychological influences on risk communication. This article reviews risk communication research appearing in the published literature since 1996. Among studies, social trust, the social amplification of risk framework, and the affect heuristic figured prominently. Also common were studies examining the influence of risk in the mass media. Among these were content analyses of media coverage of risk, as well as investigations of possible effects resulting from coverage. The use of mental models was a dominant method for developing risk message content. Other studies examined the use of risk comparisons, narratives, and visuals in the production of risk messages. Research also examined how providing information about a risk's severity, social norms, and efficacy influenced communication behaviors and intentions to follow risk reduction measures. Methods for conducting public outreach in health risk communication rounded out the literature.

The importance of news media in pharmaceutical risk communication: proceedings of a workshop

In response to mass media's role in the national and global system of pharmaceutical risk communication, the Centers for Education and Research on Therapeutics (CERTs) convened a 'think tank' session on the 'Importance of Media in Pharmaceutical Risk Communication'. Prominent journalists and experts from the pharmaceutical industry, academia, medical practice and government were invited to consider the benefits and challenges of improving the way we communicate the benefits and risks of therapeutics via mass media, especially news media. Workshop discussions revealed a paucity of systematic research directed towards understanding how and why news media report on therapeutic risk, the impact of this coverage and how coverage can be improved. Consequently, participants produced a research agenda capturing the key aspects of the flow of information around this topic, including the meaning of risk, how news audiences process and use therapeutic risk information in the news, how and why news organizations report on therapeutic risk, and the role and impact of the pharmaceutical industry, government officials and academic researchers as sources of therapeutic risk information. The workshop ended with a discussion on action items addressing what news professionals, representatives of regulatory agencies and the medical products industry, and academic researchers can and should do to enable news media to effectively report therapeutic risk information. In sum, this proceedings report provides an outline for developing mass media risk communication research, influencing the practices of journalists and expert sources and ultimately, improving the quality of the public's life.

Are we getting it right?

Beck’s “risk society” is alive. From this starting point the article assumes that risk today has to be addressed in a cultural way, taking into account that risk was not a cultural feature of the Second World War society. Among the tools for addressing the question are risk-communication research and practice, which focus on the exchange of information between all the parties concerned because it is in the framework of the communication process that risk brings together scientific uncertainty and value judgements in ways that are intimately related to politics, people’s lifestyles and the nature of our democracy.

Communication triage: an anthrax case study.

DURING A TERRORISM ATTACK, harried government officials can’t always communicate equally well to everyone. Thus, agencies must decide how to allocate time and personnel, the scarcest resources of all. Just as medics triage the wounded on the battlefield, communicators on the front lines of the war on terrorism separate “urgent” from “later” tasks. They must decide: Which populations are the most important to reach? When? What information is the most critical to convey? Risk communication research in an area of New Jersey that had no cases of anthrax illustrates the need for communication triage. During the anthrax attacks of 2001, phone calls, e-mails, and faxes overwhelmed local, county, and state agencies in New Jersey. Most state and federal resources were directed at the Hamilton postal facility, which was closed on October 18 because anthrax was diagnosed in a worker there (see Fig. 1 for timeline of events). While others have documented the events on the front lines at the Hamilton facility,1 in this article we describe the communication siege at the Monmouth Processing and Distribution Center that included erroneous media reports of two cases of anthrax. The Monmouth experience illustrates the need for government officials to develop ways to communicate with populations who consider themselves to be at risk, even though they may not be in the immediate area of exposure. Developing criteria for audience triage might help define specific secondary audiences. Our research is based on more than 20 interviews with public health professionals, emergency responders, police officers, elected officials, health practitioners, and other decision makers, combined with extensive document review (including media coverage, agency documents, and electronic correspondence to listservs). All quotes, unless otherwise noted, were obtained in these interviews. To ensure the confidentiality of sources, we use ambiguous references to interviewees’ gender. Because one of the goals of terrorism is to make many people feel like they are vulnerable to attack, we argue that the lessons learned about communication triage from Monmouth are particularly important for leaders in areas that may never be directly exposed to a weapon such as anthrax:

Reporting pesticide assessment results to farmworker families: development, implementation, and evaluation of a risk communication strategy.

The collection of environmental samples presents a responsibility to return information to the affected participants. Explaining complex and often ambiguous scientific information to a lay audience is a challenge. As shown by environmental justice research, this audience frequently has limited formal education, increasing the challenge for researchers to explain the data collected, the risk indicated by the findings, and action the affected community should take. In this study we describe the development and implementation of a risk communication strategy for environmental pesticide samples collected in the homes of Latino/a migrant and seasonal farmworkers in a community-based participatory research project. The communication strategy was developed with community input and was based on face-to-face meetings with members of participating households. Using visual displays of data effectively conveyed information about individual household contamination and placed it in the context of community findings. The lack of national reference data and definitive standards for action necessitated a simplified risk message. We review the strengths and weaknesses of such an approach and suggest areas for future research in risk communication to communities affected by environmental health risks.

Hormesis and risk communication.

Hormesis has been defined as a dose-response relationship in which there is a stimulatory response at low doses, but an inhibiting response at high doses, resulting in a U- or inverted U-shaped dose response. Toxic agents that are detrimental to human health above certain threshold levels may induce positive effects at a dose that is significantly lower than the NOAEL level. In spite of the evidence for hormesis effects, the topic is still a matter of high controversy among toxicologists. Facing this ambiguity, the article raises the question: how should risk communication be arranged in a situation of high ambiguity, lack of empirical certainty about the effects, major policy dilemmas and significant equity problems? The article summarizes the main results of risk communication research and applies these results to the question of hormesis. First, it explains the main context variables that impact on the success or failure of any risk communication program. These refer to i) the levels of the risk debate, ii) the socio-political style of regulation, iii) different types of audiences, and iv) subcultural prototypes. Secondly, the paper addresses the major functions of risk communication: i) dealing with public perception; ii) gaining trust and credibility; iii) involving stakeholders in the communication process. The last section draws some conclusions for improving risk communication on issues of hormesis.

Informed Consent for Eliciting Environmental Values

Agreeing to participate in a study eliciting environmental values means agreeing to abide by the commitment implied by any proposal that one accepts or rejects in it. That might mean anything from addressing the gist of an issue to expressing an explicit willingness to pay for an environmental change. By soliciting such participation, investigators promise to provide the information that participants need in order to evaluate the proposals being presented. This paper proposes a standard for providing such information that must be met in order to conduct valid and ethical value-elicitation studies. Namely, investigators must secure the informed consent of participants. Drawing on research in risk analysis and communication, this approach allows setting priorities among the facts that could conceivably be conveyed. It also leads to two general strategies for increasing the capacity of the communication channel. The paper concludes by discussing how the policy relevance of value-elicitation studies depends o...

News Media Discourse and the State of Public Opinion on Risk

With reference to the ‘theoretical crisis’ of those media researchers who have come to the conclusion that much of their work has been undermined by a fuller recognition of the complexity of symbolic production and exchange, this paper presents a critical summary of the potential for ‘new audience studies’ to call into question some of the basic premisses of theories of risk communication. This may give practitioners reason to jettison the popular view that risk controversies result from the discrepancies between expert and lay perceptions of the magnitude of hazards. Moreover, it certainly might be used to alert them to the possibility that media representations of risk, at least in their own terms, may have little bearing upon people's everyday worries and concerns. Risk communication researchers would do better to focus upon the specific dynamics of the political and economic interrelationships between news sources and their vested interests, in securing the power to influence the symbolic representation of public issues.

Ethical Issues in Risk Communication: Continuing the Discussion*

Proposed in this article is one possible framework for classifying multiple types of ethical issues in risk communication research and practice to help continue a discussion initiated in 1990 by Morgan and Lave. Some of the questions that each stage of the process for planning risk communication strategies appears to pose for ethics are discussed (e.g., selecting issues to be communicated, knowing the issue, dealing with constraints). Also discussed briefly are some issues raised by the possibility that risk communicators aspire to the status of a profession. The purpose is to foster discussion rather than issue a conclusive statement on the topic, because its very nature makes a definitive pronouncement indefensible.

New directions for risk communication research: a discussion with additional suggestions.

The papers by Huerta and Macario and Kreuter share the theme of suggesting new directions for risk communication research in cancer prevention and control. Huerta and Macario remind us once again that sociocultural factors must be considered when conducting risk communication research on underserved populations. Of special note is their recommendation to target the family, which could introduce a compelling new chapter in risk communication research in cancer prevention and control. In contrast, Kreuter challenges us to consider multiple cancer risks and risk-reducing behaviors in our research and provides a provocative framework for achieving this goal. Given this common theme and the need to position specific recommendations within the larger context of other competing research questions, this paper also highlights several additional recommendations for future research. These recommendations include the following: more research on risk presentation; establishing guidelines for measuring risk; additional research testing strategies to de-bias optimistic and pessimistic perceptions of risk and evaluating risk communication as a strategy for behavior change; more research investigating the sociology of risk communication, with a special emphasis on the family as the unit of investigation; and, finally, more research that specifically targets underserved populations in diverse community settings.

Ethical issues in risk communication: continuing the discussion.

Proposed in this article is one possible framework for classifying multiple types of ethical issues in risk communication research and practice to help continue a discussion initiated in 1990 by Morgan and Lave. Some of the questions that each stage of the process for planning risk communication strategies appears to pose for ethics are discussed (e.g., selecting issues to be communicated, knowing the issue, dealing with constraints). Also discussed briefly are some issues raised by the possibility that risk communicators aspire to the status of a profession. The purpose is to foster discussion rather than issue a conclusive statement on the topic, because its very nature makes a definitive pronouncement indefensible.

Cancer risk communication-what we need to learn.

Participants were charged with “identifying the most pressingand important basic and applied research questions in cancer riskcommunication.” Specifically, participants were asked to ad-dress two questions: 1) Which underlying processes in cancerrisk communication need to be better understood to advance thefield? and 2) How can we advance our ability to conduct theory-based risk communication research in the real-world context ofcancer information? A third question was advanced in the courseof the discussion: What research is needed to help accelerate theadoption of “best practices” in primary care and other settings inwhich cancer risk information is routinely communicated?