Risk Messages Research Articles

‘Polony panic’: News values and risk messages in news coverage of the South African listeriosis outbreak of 2017–2018

During food-borne disease outbreaks, people get most of their information about food safety and risk from the news media. Best practice in risk messaging requires the rapid sharing of information to minimise harm, while expressing empathy, accountability, and commitment. The journalistic processes through which news is shaped can prioritise information differently, potentially limiting informed decision-making. The South African listeriosis outbreak (2017–2018) was the biggest in global history and generated considerable media attention. Using ‘social attenuation of risk theory’ and ‘gatekeeping theory’, combined with ‘crisis and emergency risk communication best practices’ as guiding principles, in this study we aimed to analyse which components of risk message content and which news factors were prioritised by news media during the outbreak. Content analysis of 91 listeriosis-related newspaper articles revealed that the most common risk messaging practices included were information about ‘what is known’ and ‘which foods to avoid’. News factor analysis indicated ‘relevance’ was omnipresent, and ‘controversy’ was the second most frequently encountered factor. Overall, our findings suggest that only some best practices featured in the risk message media content, while others were mostly absent. This should be considered when developing future risk communication strategies related to food safety.

Examining the relationship between media representations of typhoon-related issues and public risk perception

Japan is prone to typhoons and has accumulated a wide range of knowledge about preparing for typhoon disasters. With the development of the Internet, risk information associated with typhoon disasters has increased in online sites. In the pre-emergency phase, media coverage serves as an important guideline for individual disaster mitigation actions. However, depending on which aspects of risk are portrayed in media, attention may be focused only on a few specific risky areas or events. When people do not perceive risk correctly, the risk message can be misleading for mitigation actions. This study conducted a quantitative content analysis to examine how the risk of typhoons was understood by users through online news stories concerning Typhoon Hagibis in 2019 during the pre-emergency phase. Our results found that perception of typhoon risk was distorted by previous typhoon disaster coverage. Additionally, disinformation that could cause confusion in disaster prevention behaviors, was spread on online message boards. Bulletin boards have the potential to inform many people of social norms that encourage them to be well prepared for typhoons. According to the content analysis of online comments, online users indicated that mandatory orders from the government provide the only excuse for missing work during a crisis. Risk managers should monitor the spread of inaccurate information about disaster prevention activities and convince companies to conduct pre-disaster preparedness planning with employees. Clear presentation of social norms on disaster prevention make it easier for people to take disaster prevention actions.

Examining reactions to smoking and COVID-19 risk messages: An experimental study with people who smoke.

BackgroundSmoking cigarettes worsens COVID-19 outcomes, and news media and health agencies have been communicating about that. However, few studies have examined how these messages affect attitudes, beliefs, and behavioral intentions of people who smoke. These are critical variables that can inform public health campaigns to motivate quitting smoking during the COVID-19 crisis.MethodsIn August 2020, we conducted an online experiment in the U.S. with 1,004 adults who smoke. Participants were randomized to one of four message conditions: COVID-19 risk, smoking risk, combined risk of smoking for COVID-19 severity, or a non-risk control. Outcomes were message reactions (emotions and reactance), attitudes and beliefs (severity, susceptibility, self-efficacy, response efficacy for smoking and COVID-19, and conspiracy beliefs), and behavioral intentions (smoking intentions, COVID-protective intentions, and information-seeking).ResultsMultivariate analysis of covariance (MANCOVA) showed that combined risk messages elicited higher perceived severity of smoking-related disease than control messages. Similarly, the combined risk condition resulted in greater intentions to quit smoking in the next month (vs. COVID-19 risk condition) and intentions to reduce smoking in the next 6 months (vs. smoking risk and control; ps < .05). Multivariate logistic regression found that exposure to the combined risk messages (vs. control as referent) was associated with higher odds of mask-wearing intentions in the next 2 weeks (AOR = 1.97).ConclusionsHealth agencies can possibly use messages that communicate about the combined risk of smoking and COVID-19 as a novel strategy to motivate people who smoke to quit and take protective action for COVID-19.

Effects of self-affirmation on university students’ processing of health risk messages related to sedentary behavior

Objective Examine effects of self-affirmation on university students’ processing of health risk messages related to sedentary behavior. Participants Eighty-eight students from a Canadian university (females = 53; males = 35; M age = 21.74, SD = 5.36) participated during the 2018–2019 academic year. Methods Participants were randomized to a self-affirmation (n = 43) or control group (n = 45), watched a video conveying sedentary behavior risk messages, and completed measures of acceptance, derogation, risk perceptions, negative affect, and intentions. A one-way between-groups multivariate analysis of variance (MANOVA) examined effects of condition on the combined set of outcome variables. Results Self-affirmation had no observable effect on any outcome variables. Conclusion Self-affirmation did not appear to impact students’ reactions to sedentary behavior risk messages. Given the lack of a manipulation check, however, this finding must be interpreted with caution. The Trigger and Channel framework offers a useful account of factors that influence self-affirmation effects. Implications and future research directions are discussed.

Supplemental Material for Ambiguity and Unintended Inferences About Risk Messages for COVID-19

Supplemental Material for Ambiguity and Unintended Inferences About Risk Messages for COVID-19

PERSEPSI TENTANG RISIKO BREAKTHROUGH INFECTION COVID-19 DALAM LINGKUNGAN HEALTH RISK MESSAGES

The Covid-19 vaccination rate continues to increase, it is important to pay attention to the possibility of a breakthrough infection, which is a viral infection that occurs after a person has been vaccinated. This is a case that is expected to occur in some of those who have received the vaccine, as no vaccine for any disease is 100 percent effective. During the time of living in this period of the Covid-19 pandemic, people are always exposed to information about the dangers or threats of exposure to the virus, known as health risk messages. This study was conducted to explain how a number of individual characteristics in the health risk message information environment correlate to their attitudes towards the risk of exposing Covid-19. This online survey of people who have received the Covid-19 vaccine found that several variables related to lifestyle and disease history were correlated to perceptions of the risk of exposure to Covid-19. It also confirms that there is a positive correlation between awareness of the amount of risk an individual has and perceptions of the risk of exposing Covid-19.

Now or never? Temporal framing in risk messages and the moderating effect of comparative optimism

Risk messages inform consumers about relevant risks and typically recommend preventive behaviors such as being more physically active or taking out occupational disability insurance. Often, the appeals include some form of time reference, such as “find out about disability insurance this month” or “find out about disability insurance this year”. In general, the effects of such proximal compared to distal time references on compliance intention may be positive or negative, and we examine how the effects depend on consumers’ comparative optimism. In two studies in the context of occupational disability insurance, proximal temporal framing proved more effective than distal framing among comparative optimists but not among nonoptimists. We recommend that when targeting comparative optimists, risk message designers should use proximal temporal framing in their recommendations.

Changing pace: Using implementation intentions to enhance social distancing behavior during the COVID-19 pandemic.

Since the first case of COVID-19 in the U.S. on January 20, 2020, the disease caused by the new strain of coronavirus has spread exponentially across the country. While the spread of this disease can be significantly slowed if people practice "social distancing," it is difficult to break old habits and acquire new behaviors at the needed speed. The purpose of this study is to challenge how health risk messages are currently communicated (specifically by considering how the Center of Disease Control (CDC) communicates its recommendations for social distancing) and suggest an alternative way. We tested and applied the use of a robust behavioral intervention known as "if-then" plans (plans that spell out in advance how one wants to achieve a goal they have previously set) to encourage the acquisition of a new behavior (e.g., social distancing) during this time of crisis. Using a longitudinal mixed design (within-/between-subjects study) daily diary study, we hypothesized and observed (via multilevel modeling) that those randomized into the experimental group (those who created and practiced if-then plans) demonstrated increased social distancing over time, whereas engagement in social distancing did not change in the control condition (those who observed the CDC guidelines). These results were sustained in a 3-week follow-up examination for those who were strongly committed to the goal to social distance. Such evidence suggests that risk communication messaging that includes if-then plans is an effective way of acquiring new behaviors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

COVID19 vaccine intentions in South Africa: health communication strategy to address vaccine hesitancy

BackgroundVaccine hesitancy is emerging as a significant challenge in many parts of the world in the fight against the COVID19 pandemic. The continued infection amongst the unvaccinated can lead to a heightened risk of further virus mutation, exposing even those vaccinated to new virus strains. Therefore, there are social benefits in minimising vaccine hesitancy. The objective of this study is to assess the level of COVID19 vaccine hesitancy in South Africa, identify the socio-economic patterns in vaccine hesitancy and highlight insights from the national survey that can inform the development of a COVID-19 vaccination acceptance communication campaign.MethodsThe study uses the nationally representative National Income Dynamics Study - Coronavirus Rapid Mobile Survey (NIDS-CRAM) survey. The analysis combines univariate and bivariate statistics, as well as multivariate regression models like binomial/ordinal and multinomial logit.ResultsThe study finds that vaccine acceptance is lower than that of non-pharmaceutical intervention like face-mask use. Only 55% fully accept the vaccine, while a further 16% are moderately accepting of vaccines. Together, vaccine acceptance is estimated at 70.8%, and vaccine hesitancy against COVID19 is estimated at 29.2% amongst the adult South African population.The study has identified the perceived risk of infection with the mediating role of efficacy as a key predictor of vaccine intention. Higher awareness of COVID19 related information and higher household income are correlated with lower vaccine hesitancy. The non-black African population group has significantly high vaccine hesitancy compared to black Africans.ConclusionsThere are other significant differences across socio-economic and demographic variables in vaccine hesitancy. From a communication perspective, it is imperative to continue risk messaging, hand in hand with clearer information on the efficacy of the vaccines.

Integrating Self-Report and Psychophysiological Measures in Waterpipe Tobacco Message Testing: A Novel Application of Multi-Attribute Decision Modeling.

Background: Waterpipe (i.e., hookah) tobacco smoking (WTS) is one of the most prevalent types of smoking among young people, yet there is little public education communicating the risks of WTS to the population. Using self-report and psychophysiological measures, this study proposes an innovative message testing and data integration approach to choose optimal content for health communication messaging focusing on WTS. Methods: In a two-part study, we tested 12 WTS risk messages. Using crowdsourcing, participants (N = 713) rated WTS messages based on self-reported receptivity, engagement, attitudes, and negative emotions. In an in-lab study, participants (N = 120) viewed the 12 WTS risk messages while being monitored for heart rate and eye-tracking, and then completed a recognition task. Using a multi-attribute decision-making (MADM) model, we integrated data from these two methods with scenarios assigning different weights to the self-report and laboratory data to identify optimal messages. Results: We identified different optimal messages when differently weighting the importance of specific attributes or data collection method (self-report, laboratory). Across all scenarios, five messages consistently ranked in the top half: four addressed harms content, both alone and with themes regarding social use and flavors and one addiction alone message. Discussion: Results showed that the self-report and psychophysiological data did not always have the same ranking and differed based on weighting of the two methods. These findings highlight the need to formatively test messages using multiple methods and use an integrated approach when selecting content.

Risk and Health Communication during Covid-19: A Linguistic Landscape Analysis

ABSTRACT Since the outbreak of Covid-19 health communicators around the globe have had to reach, urge, and persuade individuals and communities to adopt appropriate health protective behaviors. They have used a mix of communication channels, including outdoor media and public signage which are the focus of this paper. Drawing on a comparative linguistic landscape analysis, this paper critically examined the amount, content, and prominence of Covid-19 signage in Hackney, a London borough severely hit by the first wave of the pandemic. Having analyzed 1288 signs collected between May and July 2020, we found significant differences in Covid-19 signage between deprived and less deprived areas. These differences (e.g., in messaging about staying at home) have created inequalities in access to Covid-19 related health information and guidance. We also explored the changes in Covid-19 signage over time and the tailoring of risk and health messages to minority communities.

Unintended Effects of Risk Communication: Impacts of Message Fatigue, Risk Tolerance, and Trust in Public Health Information on Psychological Reactance

How individuals experience unintended effects of risk messages is an understudied area. Focusing on three types of unintended effects (i.e., message fatigue, risk tolerance, and psychological reactance) associated with health risk communication, we conducted an online survey among Italian adults (N = 507) to investigate how perceived message fatigue and risk tolerance might induce psychological reactance and whether trust in public health information might mediate this relationship. Results from mediation models revealed: (a) greater message fatigue and risk tolerance increased psychological reactance; (b) greater message fatigue and risk tolerance led to distrust in government-shared health information; (c) trust in public health information mediated the effects of message fatigue and risk tolerance on psychological reactance. Theoretical and practical implications are discussed.

Health warning messages on cigarette packs: how young smokers process it.

SummaryOne of the major smoking prevention strategies has been to educate the public and increase people’s awareness, using health-warning messages. However, many young people continue smoking without paying attention to health risk messages on cigarette packets in Iran. Hence, this study was conducted to examine the processing route of anti-smoking messages and influencing cognitive factors based on the Elaboration Likelihood Model. This cross-sectional study was correlational in nature. The non-probability sample consisted of 387 tobacco smokers in the age range of 18 to 30 years old. The study was conducted between July and November of 2018 in Tabriz, Iran. A researcher-designed questionnaire was used for the purpose of data collection. No causal inferences were drawn due to the non-experimental nature of the investigation. It was found that tobacco smokers often processed the health warning messages through the central route. Perceived severity, smoking abstinence self-efficacy, and psychological dependence were predictors of message processing through the central route. The results supported the conceptual model of cognitional predictors of the processing route. To design and execute effective health warning messages to quit smoking, it is recommended to consider cognitive factors as a means to enhance critical thinking about the content of the health-warning message.

Development and testing of relative risk-based health messages for electronic cigarette products

BackgroundHealth messages on e-cigarette packs emphasise nicotine addiction or harms using similar wording to warnings on cigarette packs. These may not be appropriate for e-cigarettes which constitute a reduced risk alternative for smokers. This research aimed to (1) develop and test a selection of relative risk messages for e-cigarette products; (2) compare these to the two current EU Tobacco Products Directive (TPD) nicotine addiction messages; and (3) explore differences between smokers, non-smokers and dual users.MethodTwenty-six messages focusing on either harm-reduction or cessation were developed and rated by multidisciplinary experts for accuracy, persuasiveness and clarity. The eight highest ranking messages were compared alongside the TPD messages in a sample of 983 European residents (316 smokers, 327 non-smokers, 340 dual users) on understandability, believability and convincingness.ResultsOn all three constructs combined, the two TPD messages rated the highest, closely followed by four relative risk messages “Completely switching to e-cigarettes lowers your risk of smoking related diseases”, “Use of this product is much less harmful than smoking”, “Completely switching to e-cigarettes is a healthier alternative to smoking”, and “This product presents substantially lower risks to health than cigarettes” which did not differ statistically from the TPD messages. Non-smokers rated TPD1 significantly higher overall than dual users. Dual users rated “This product is a safer alternative to smoking” significantly higher than non-smokers. Messages did not differ on understandability.ConclusionsThese alternative messages provide a useful resource for future research and for policy makers considering updating e-cigarette product labelling.

COVID-19: A Cross-Sectional Study of Healthcare Students' Perceptions of Life during the Pandemic in the United States and Brazil.

Societal influences, such as beliefs and behaviors, and their increasing complexity add to the challenges of interactivity promoted by globalization. This study was developed during a virtual global educational exchange experience and designed for research and educational purposes to assess personal social and cultural risk factors for students’ COVID-19 personal prevention behavior and perceptions about life during the pandemic, and to inform future educational efforts in intercultural learning for healthcare students. We designed and implemented a cross-sectional anonymous online survey intended to assess social and cultural risk factors for COVID-19 personal prevention behavior and students’ perceptions about life during the pandemic in public health and healthcare students in two public universities (United States n = 53; Brazil n = 55). Statistically significant differences existed between the United States and Brazil students in degree type, employment, risk behavior, personal prevention procedures, sanitization perceptions, and views of governmental policies. Cultural and social differences, risk messaging, and lifestyle factors may contribute to disparities in perceptions and behaviors of students around the novel infectious disease, with implications for future global infectious disease control.

COVID-19 Crisis Communication: The Strategic Use of Instagram Messages by the Bahraini Ministry of Health in Light of the Crisis and Emergency Risk Communication Model (CERC)

While social media is being increasingly used for health crisis communication, few studies, especially in the Arab region, have examined how it can improve strategic communication during various phases of any health crisis. The Crisis and Emergency Risk Communication (CERC) model is one of the frameworks that focus on strategic communication of health crises through social media. Considering the limited number of Arab studies investigating the application of the CERC model during health crisis management, this study seeks to identify how social media can be utilized to implement the CERC model, by examining the uses of Instagram by the Bahraini Ministry of Health (MOH) in managing the COVID-19 pandemic. The results suggest that the MOH’s Instagram account was used strategically in this case. Results also provide information on how the MOH closely followed the actions recommended in the CERC model, implementing the different crisis stages: risk messages, warnings, preparations, uncertainty reduction, and efficacy.

Physical risk messaging enhances favorable attitudes toward mask wearing

AbstractWhile masks slow the transmission of COVID‐19, many resist wearing them. Extant public service messaging focuses on creating social norms around mask wearing. Drawing on protection motivation theory, we conduct a copy test to determine whether focusing on the physical risks or focusing on the social risks of contracting COVID‐19 is more persuasive in motivating mask wearing. We find that physical risk messaging is more persuasive than social risk messaging and find that the effect is partially mediated by fear of COVID‐19. The mediation is moderated by germ aversion. Specifically, we find people who are high in germ aversion respond to both physical and social risk messaging. However, people low in germ aversion respond only to physical risk messaging—and these are the people who are less likely to wear masks. Our findings offer public health agencies a fresh approach for encouraging those who are resistant to mask wearing to wear a mask.

Risk sharing on Twitter: Social amplification and attenuation of risk in the early stages of the COVID-19 pandemic

Social media trust and sharing behaviors have considerable implications on how risk is being amplified or attenuated at early stages of pandemic outbreaks and may undermine subsequent risk communication efforts. A survey conducted in February 2020 in the United States examined factors affecting information sharing behaviors and social amplification or attenuation of risk on Twitter among U.S. citizens at the early stage of the COVID-19 outbreak. Building on the social amplification of risk framework (SARF), the study suggests the importance of factors such as online discussion, information seeking behaviors, blame and anger, trust in various types of Twitter accounts and misinformation concerns in influencing the spread of risk information during the incipient stages of a crisis when the publics rely primarily on social media for information. An attenuation of risk was found among the US public, as indicated by the overall low sharing behaviors. Findings also imply that (dis)trust and misinformation concerns on social media sources, and inconsistencies in early risk messaging may have contributed to the attenuation of risk and low risk knowledge among the US publics at the early stage of the outbreak, further problematizing subsequent risk communication efforts.

The Saudi Ministry of Health's Twitter Communication Strategies and Public Engagement During the COVID-19 Pandemic: Content Analysis Study.

BackgroundDuring a public health crisis such as the current COVID-19 pandemic, governments and health authorities need quick and accurate methods of communicating with the public. While social media can serve as a useful tool for effective communication during disease outbreaks, few studies have elucidated how these platforms are used by the Ministry of Health (MOH) during disease outbreaks in Saudi Arabia.ObjectiveGuided by the Crisis and Emergency Risk Communication model, this study aimed to explore the MOH’s use of Twitter and the public’s engagement during different stages of the COVID-19 pandemic in Saudi Arabia.MethodsTweets and corresponding likes and retweets were extracted from the official Twitter account of the MOH in Saudi Arabia for the period of January 1 through August 31, 2020. Tweets related to COVID-19 were identified; subsequently, content analysis was performed, in which tweets were coded for the following message types: risk messages, warnings, preparations, uncertainty reduction, efficacy, reassurance, and digital health responses. Public engagement was measured by examining the numbers of likes and retweets. The association between outbreak stages and types of messages was assessed, as well as the effect of these messages on public engagement.ResultsThe MOH posted a total of 1393 original tweets during the study period. Of the total tweets, 1293 (92.82%) were related to COVID-19, and 1217 were ultimately included in the analysis. The MOH posted the majority of its tweets (65.89%) during the initial stage of the outbreak. Accordingly, the public showed the highest level of engagement (as indicated by numbers of likes and retweets) during the initial stage. The types of messages sent by the MOH significantly differed across outbreak stages, with messages related to uncertainty reduction, reassurance, and efficacy being prevalent among all stages. Tweet content, media type, and crisis stage influenced the level of public engagement. Engagement was negatively associated with the inclusion of hyperlinks and multimedia files, while higher level of public engagement was associated with the use of hashtags. Tweets related to warnings, uncertainty reduction, and reassurance received high levels of public engagement.ConclusionsThis study provides insights into the Saudi MOH’s communication strategy during the COVID-19 pandemic. Our results have implications for researchers, governments, health organizations, and practitioners with regard to their communication practices during outbreaks. To increase public engagement, governments and health authorities should consider the public’s need for information. This, in turn, could raise public awareness regarding disease outbreaks.

Risks Elaborated vs. Risks Downplayed: The Effect of Risk Comparisons in Mainstream Media During Covid-19 on Risk Perceptions and Anxiety Levels

This study examines the effects of risk comparisons in mainstream media during the Covid-19 outbreak that either expressed the severity of the outbreak or downplayed it by comparing the mortality rates of the disease to those of other risks. In an online experiment of undergraduate students at a large university in the U.S. Mountain West (n = 78) in early May 2020, we found that trust in government agencies played an important role in how people interpret risk messages in media. When the risks are amplified, those who hold low levels of trust in government agencies are more likely to report higher levels of anxiety. When risks are downplayed, people who hold high levels of trust in government agencies are more likely to report greater risk perceptions than those who hold low levels of trust in government agencies. The implications are discussed.