Risk Perception Attitude Framework Research Articles

Beyond perceived risk: COVID-19 vaccination more strongly linked to individual risk perception in wheat areas than rice areas

Vaccines save lives, but vaccine hesitancy remains a global health challenge. That makes it critical to explore the factors that influence whether people get vaccinated. Perceived risk is a pivotal factor in traditional theories of health behavior, such as the Risk Perception Attitude framework and the Health Belief Model. However, studies have found that these models are less predictive of COVID-19 vaccination in some cultures. Studies that test culture by comparing nations are useful, but nations have different healthcare systems and policies that are hard to equate and control for. We addressed this question by testing regional cultural differences in China. Drawing on the rice theory, we compared residents in China's historical rice-farming areas (which are more interdependent) with those in wheat-farming areas (which are more independent). Our survey data from 1872 participants in 29 provinces found that models of perceived risk explained COVID-19 vaccination mainly in historically wheat-farming areas. Conversely, in historically rice-farming areas, perceived risk did not explain vaccination behavior. These findings suggest that cultural factors that are rooted in historical farming practices influence vaccination behaviors. By comparing regions within the same country, we can rule out confounds of national policy and healthcare systems. These insights could help policymakers understand how to tailor vaccination campaigns to people from different cultures.

The role of safety climate in occupational health and safety information seeking: extending risk perception attitude framework

PurposeThis study is a theory-building effort to extend the risk perception attitude (RPA) framework by considering an organization-related factor. Specifically, this study examined how an organization-related factor, namely safety climate, and individual-related factors, namely risk perception and efficacy belief, jointly influence flight attendants’ occupational health and safety (OHS) information seeking intent.Design/methodology/approachAbout 486 flight attendants from an international air carrier, based in Hong Kong, participated in an online survey. Hierarchical regression was employed to examine the three-way interaction of risk perception, efficacy belief, and safety climate.FindingsResults showed that safety climate moderated the effect of efficacy belief on the relationship between risk perception and OHS information seeking intent. For flight attendants who perceived a high safety climate, those who felt more efficacious had a higher intent for OHS information seeking than those who felt less efficacious. In contrast, for flight attendants who perceived a low safety climate, when they perceived a high level of risk, those with low efficacy had a higher information seeking intent than those with high efficacy.Originality/valueAlthough the RPA framework has shown its potential to explicate how individual employees engage in OHS information seeking behavior, the framework has largely overlooked the importance of organization-related factors as an influential shaping force of individual employees’ behavior. To fill this research gap, this study extends the RPA framework by examining how safety climate moderates the relationship between risk perception and efficacy belief on flight attendants’ OHS information seeking intent. Safety climate also plays an important role in segmenting audience groups for OHS promotion.

Application of the extended parallel process model and risk perception attitude framework to obesity knowledge and obesity prevention behaviors among Korean adults

BackgroundPerceiving oneself as obese has been associated with weight loss attempts. However, such a perception may not sufficiently drive significant weight reduction in many individuals. Hence, relying solely on the traditionally emphasized perceived risk of behavioral changes in obesity is challenging. This study used an extended parallel process model and a risk perception attitude framework to explore the influence of perceived risk and perceived efficacy on individual obesity knowledge and obesity prevention behaviors.MethodsData were obtained from 1,100 Korean adults aged 40–69 years through an online survey conducted in October 2022. Multinomial logistic regression and analysis of variance were employed to assess the relationships among perceived risk, perceived efficacy, obesity knowledge, and obesity prevention behaviors.ResultsSex was associated with being underweight, overweight, and obese. Moreover, perceived severity was associated with obesity, whereas perceived susceptibility was associated with overweight and obese. Response efficacy was related to being overweight alone, whereas self-efficacy was associated with being underweight, overweight, and obese. The main effects of sex and perceived risk, and their interaction effect were statistically significant for obesity knowledge. Additionally, the main effects of sex, perceived risk, and perceived efficacy on obesity prevention behaviors were statistically significant.ConclusionsThe extended parallel process model and risk perception attitude framework proved effective in classifying obesity based on body mass index, obesity knowledge, and obesity prevention behaviors.

Mechanisms of Climate Change Media Effects: Roles of Risk Perception, Negative Emotion, and Efficacy Beliefs

ABSTRACT In the context of climate change communication, this study explores the process through which exposure to media messages about a risk leads to recommended behavioral intentions. We propose a model of this process based on the Extended Parallel Process Model (EPPM) and the Risk Perception Attitude (RPA) framework. Our model analyzes how risk perception, negative emotion, and efficacy beliefs mediate and moderate the effects of media messages on people’s intention to engage in pro-environmental behaviors. A national survey among 1,000 adults in South Korea was analyzed, and the fitting of PROCESS Models 4 and 15 yielded four main findings. First, media exposure was directly and positively related to risk perception, negative emotion, and pro-environmental behavioral intention. However, the significant relation between media exposure and behavioral intention was partly conditional upon efficacy beliefs. Second, risk perception and negative emotion were also significantly related to behavioral intention conditional upon efficacy beliefs. Third, efficacy beliefs significantly moderated the relation between risk perception and behavioral intention, but not between negative emotion and behavioral intention. Fourth, efficacy beliefs served as a moderator for the indirect effect of media exposure on behavioral intention via risk perception and negative emotion.

Development and validation of fall risk perception scale for patients with Parkinson's disease.

Perception assessment plays an important role in fall risk awareness and fall prevention. Parkinson's disease patients with motor dysfunction are at high risk of falling. Currently, no instrument has been explicitly crafted to assess the risk perception of fall in PD patients. The purpose of this study was to develop and validate the fall risk perception scale for PD patients (FRPS-PD), providing healthcare professionals with a effective assessment tool to enhance proactive fall prevention initiatives. Based on the Proactive Health theory and Risk Perception Attitude (RPA) Framework, the questionnaire was developed through literature review, semi-structure interview, expert consultation and pilot testing. A total of 428 patients with PD from Grade A tertiary hospitals in Shanghai, Hangzhou and Anhui from January 2023 to July 2023 were recruited. The items and dimensions in the scale were explored and confirmed using item-analysis, content validity, exploratory factor analytical (EFA), confirmatory factor analytical (CFA), internal consistency and test-retest reliability analysis. A total of 16-items, 2-dimensions structure were identified, including 12 items of risk perception and 4 items of self-efficacy dimension. The cumulative variance of EFA model was 73.669%, further CFA showed that acceptable model fit (χ2/df = 2.226, RMSEA = 0.074, NF = 0.928, TLI = 0.951, CFI = 0.959, GFI = 0.887 and AGFI = 0.848). The content validity index was 0.956. The reliability of the scale was 0.952 using Cronbach's α coefficient method. The test-retest reliability was 0.944. The FRPS-PD is a valid and reliable measurement for evaluating fall risk perception level for individuals with PD in mainland China.

Analysis of the Fourth Vaccination Intention of the Elderly for COVID-19 Based on RPA Theory

With the open management of the epidemic in China, the first wave of the epidemic has passed, and the safety and health of the elderly have become a key concern in the face of the uncertain epidemic situation in the future. This study was conducted to analyze whether children would give their elderly family members a fourth dose of the Covid-19 vaccine, in addition to the third dose of the vaccine, in view of the fact that the elderly may have underlying diseases and their body functions are aging. This study uses the Risk Perception Attitude (RPA) framework to analyze not only the impression and credibility of the children in the family, but also the children's risk perception and self-efficacy and, thus, their willingness to allow their parents to receive the vaccine. Based on the questionnaire of "Elderly people receiving the fourth dose of the Covid-19 vaccine" in 2023, four seven-level scales were developed for each of the four variables, and the data were collected and analyzed for reliability and validity, and regression analysis was designed to gauge the behavior of the children in determining whether or not to vaccinate the elderly in their families under the influence of information media. It was found that media impression was deeply and positively related to risk perception and self-efficacy; media credibility was also profoundly and positively related to risk perception and self-efficacy; risk perception and self-efficacy had a significant effect on the final behavioral outcome.

Associations among risk perception, health efficacy, and health behaviors for cardiovascular disease: an application of risk perception attitude framework.

There is currently a pervasive prevalence of cardiovascular disease (CVD) risk worldwide and an inadequate amount of action is being taken to promote healthy lifestyle habits. The risk perception attitude (RPA) framework, which classifies individuals based on their risk perception and efficacy belief, enables us to predict their preventive behaviors. We applied the RPA framework to analyze CVD prevention behaviors among Chinese adults and extended its application to CVD objective risk. A cross-sectional survey was performed in two sites in Zhejiang Province, from March to August 2022, which contained self-reported CVD risk perception, objective CVD risk, efficacy belief, physical activity, healthy diet, and covariates. We used the RPA framework to categorize participants into four groups, then analysis was conducted to estimate inter-group differences in healthy behaviors. We further conducted a hierarchical logistic regression analysis with individuals' health behaviors as the dependent variable, using three blocks of independent variables. Among 739 participants, healthy physical activity and healthy diet had significant differences among four RPA groups, post hoc tests clarified that the proportion of respondents with healthy PA in the responsive group (61.6%) was significantly higher than that in the other three groups. Risk perception and efficacy belief significantly predicted health behavior against CVD; the relationship between absolute CVD risk and health behavior was moderated by efficacy belief. Early CVD risk screening is crucial, but tailored support and a proper understanding of personal risk are essential to promote healthy behaviors. Developing communication and behavioral counseling intervention strategies on the basis of the RPA framework has the potential to promote healthy behaviors for CVD prevention.

Individual and Collective Actions Against Climate Change Among Chinese Adults: The Effects of Risk, Efficacy, and Consideration of Future Consequences

In this study, we tested the core premise of the risk perception attitude framework—that perceived risk and perceived efficacy jointly affect intention—and identified consideration of future consequences (CFC) as a boundary condition of the premise in the context of mitigating climate change. Our two-wave survey ( N = 439) revealed that perceived individual-level efficacy predicted intention to perform individual behavior, whereas perceived societal-level risk predicted intention to engage in collective action. For individuals with low CFC, perceived risk and perceived efficacy’s joint effect was positively associated with intention to engage in individual behavior and collective action against climate change.

The impact of source credibility and risk perception attitudes on Americans’ willingness to participate in contact tracing applications

ABSTRACT Contact tracing has emerged as one tool to communicate infection risks with the public during the COVID-19 pandemic. This study uses source credibility and the risk perception attitude framework to interpret how Americans responded to contact tracing messages from a technology company, employer, physician, or state government. Survey participants (n = 245) were generally positive towards a contact tracing message regardless of source. Participants with high risk perceptions and low efficacy beliefs responded more strongly to appeals from their company and their physician while the low risk-low efficacy group found the state government appeal more compelling. The results suggest that several sources delivering the same health message could engage people with different risk perceptions and efficacy beliefs.

Nurse Anesthesia Diversion Prevention: A Knowledge and Needs Gap Analysis.

Substance misuse is an occupational health problem for anesthesia providers (APs). More than 10% of nurse anesthetists misuse and divert medications. No standard exists for addressing AP drug diversion. The purpose of this quality improvement project was to evaluate the use of a knowledge and needs assessment to inform the development of a successful drug diversion prevention program for certified registered nurse anesthetists (CRNAs) and student registered nurse anesthetists (SRNAs). A 28-item questionnaire, using the health belief model (HBM) and the risk perception attitude (RPA) framework, was developed to assess knowledge, beliefs, and practices of substance misuse and diversion. RPA groups were determined by level of belief in self-risk and perceived efficacy of prevention strategies. The survey was emailed to 100 CRNAs and over 100 SRNAs. Survey results were organized using the RPA framework. One hundred twelve surveys were completed. The RPA avoidant category (high-risk belief and low perceived efficacy of preventive interventions) comprised 52.5% of CRNAs; SRNAs were divided primarily among the RPA responsive category with high perceived risk and high-efficacy beliefs (38.9%) and the indifferent category of low-risk beliefs and low perceived efficacy (31.9%). Anesthesia providers have varying beliefs regarding drug misuse and diversion risks and perceptions of their ability to be successful with preventive strategies. Failure to address nurse anesthesia needs-based diversion prevention may result in missed opportunities to educate this group. Implementation of RPA-tailored interventions by health care organizations may produce effective, long-term outcomes for drug diversion within the profession.

Food consumption behavior in a health crisis: Application of the risk perception attitude framework during the COVID-19 pandemic

This study examined consumers’ food consumption behavior related to COVID-19 infection prevention based on the risk perception attitude framework. It applied the risk perception attitude framework to classify consumers into four types based on K-cluster analysis. Further, it used data from the Consumer Behavior Survey for Food 2021 to examine the main and interaction effects of perceived risk and self-efficacy on food consumption behavior related to COVID-19 infection prevention. The results demonstrated that the main effect of self-efficacy significantly affected online purchase, eat-at-home, delivery service, and takeout service, but the main effect of perceived risk was statistically significant only for online purchases and eat-at-home. Further, the interaction effect between perceived risk and self-efficacy was statistically significant for delivery service and take-out services.

Multilevel theorizing in health communication: Integrating the Risk Perception Attitude (RPA) framework and the Theory of Normative Social Behavior (TNSB).

Research testing the risk perception attitudes (RPA) framework has demonstrated that efficacy can moderate the effect of risk perceptions on behavior. This effect of efficacy has also been seen at the social-level through tests of the theory of normative social behavior (TNSB). We tested if efficacy could bridge normative factors at a social-level and risk perception at an individual-level. Data for this study come from the Reduction in Anemia through Normative Innovations (RANI) project's baseline survey in Odisha, India. We used hierarchical regressions to analyze interactions between predictors at various levels and efficacy to predict behavioral intention. Efficacy beliefs moderated the effect of injunctive norms (β = 0.07, p < 0.01), collective norms (β = 0.06, p < 0.01), and risk perception (β = 0.04, p < 0.01) on intentions. This study provides preliminary evidence for a multilevel theoretical framework.

COVID-19 and medical tourism intentions for Iran – a test of the risk perception attitude framework (RPAF)

Purpose This paper aims to examine whether medical tourism can be a frontrunner in terms of post-pandemic recovery for the industry Design/methodology/approach A mixed-method analysis of 17 interviews and 210 questionnaires involving medical tourists to Iran was applied. Findings Medical tourists perceived the risks posed by COVID-19 as a temporal one, and attitudes toward post pandemic visitation intentions remained strong. In addition, these tourists can mostly be classified into responsive individuals, who demonstrate not only high risk but also high efficacy levels to negotiate the threats posed by the pandemic. No gender differences were located between male and female medical tourists in terms of post-COVID-19 travel intentions to Iran. Originality/value This research extends the application of the risk perception attitude framework to a medical tourism context. Furthermore, medical tourists are uncovered as another segment of crisis-resistant tourists.

What moves young people? Applying the risk perception attitude framework to physical activity behavior and cardiometabolic risk.

Cardiometabolic disease risk factors, including metabolic syndrome and physical inactivity, are prevalent among young adults. However, few young adults are aware of their risk status. The risk perception attitude (RPA) framework was used to categorize participants (n = 456) enrolled in a three-arm randomized controlled weight management trial by their baseline values of cardiometabolic risk perceptions and physical activity self-efficacy. Trial recruitment occurred at two universities from 2015 to 2018 and participants were randomly assigned to one of three weight management interventions: Tailored, Targeted, Control. Cross-sectional and longitudinal analyses were conducted to examine associations between RPA category (i.e., Responsive, Indifferent, Avoidant, Proactive) and physical activity behavior. At baseline, the Responsive group had the highest amount of physical activity (mean [95% CI]: 379.2 [332.6 to 425.8] min/week), the Indifferent group had the lowest (296.7 [261.98 to 331.32] min/week), and the Avoidant/Proactive groups showed intermediate values. Over 6 months, there was a significant interaction between RPA group and intervention arm on change in physical activity adjusted for age, sex, race/ethnicity, baseline body mass index, and baseline moderate-to-vigorous physical activity (p = .017). Among Tailored intervention participants only, the Proactive participants were the only group to have an increase in physical activity (19.97 min/week) and the Indifferent participants had the most significant decrease in physical activity (127.62 min/week). Results suggest the importance of early screening for young adults to help raise awareness of cardiometabolic risk and ultimately support them in health promotion efforts.

Campaign message exposure, audience segmentation, and protective behaviors in the early stages of the COVID-19 pandemic in Vietnam

ABSTRACT Background This study examined how the Risk Perception Attitude Framework (RPA) could be used to segment audiences in the COVID-19 prevention campaign in Vietnam. It investigated how the identified segments differed regarding staying at home and mask wearing behaviors and whether exposure to prevention messages via social media and mass media might predict the identified segments. Method A cross-sectional survey (N = 360) was administered online in Ho Chi Minh City, Vietnam in the early stages of the COVID-19 outbreak in 2020. The survey captured participants’ risk perceptions, efficacy beliefs, campaign message exposure, behavioral intention, and demographic variables. Two-step cluster analysis, analysis of variance, and multinominal regression were conducted. Results Three segments were identified for staying at home behavior (avoidance group, proactive group, and responsive group) and four segments were found for mask wearing behavior (avoidance group, proactive group, moderately responsive group, and highly responsive group). Results revealed that segment membership was associated with behavioral intention and exposure to COVID-19 prevention message via social media predicted the likelihood of participants belonging to the responsive group. Conclusion Data showed that segments differed significantly regarding behavioral intention and that exposure to social media prevention messages predicted the responsive group. Findings extended the RPA to a novel behavioral context, while providing useful implications for practitioners.

Intention to seek health information on social media in Indonesia

To date, health information spreads across several social media platforms. This study aims to analyze the factors that influence the seeking health information available on social media using the Net Valence model and Risk-Perception Attitude framework. An online survey was administered to 1,308 respondents who had searched for health information on social media. Data analysis was performed using covariance-based structural equation modeling in the AMOS 24.0 software environment. This study result in gender comparison indicated different results among men and women, where the perceived risk only affected women in seeking health information on social media. In addition, perceived benefits, health self-efficacy, and subjective norms influenced the intention to seek health information on social media.

Predicting intentions to practice COVID-19 preventative behaviors in the United States: A test of the risk perception attitude framework and the theory of normative social behavior.

This study examined risk perceptions, efficacy beliefs, social norms, and their interactions as predictors of people's intention to practice four COVID-19 preventative behaviors among a U.S. sample with quotas on age, sex, ethnicity, and region (N = 336). This online survey found that perceived injunctive norms predicted intentions to clean and disinfect (β = 0.20), practice social distancing (β = 0.14), and wear a face mask (β = 0.24). Additionally, efficacy beliefs were found to attenuate the association between descriptive norm perceptions and intention to wash hands (B = -0.15) and wear a face mask(B = -0.12). The results revealed the importance of considering both psychological and social factors to promote COVID-19 preventative behaviors.

Modeling behavioral intention toward traveling in times of a health-related crisis

This study proposes an integrated model based on the Risk Perception Attitude (RPA) framework and the Theory of Planned Behavior (TPB) model to investigate behavioral intention toward traveling in times of a health-related crisis. A survey was conducted via online networks of travelers, yielding 338 valid cases. The findings indicate that health risk perception is affected by information search about the Covid-19 disease. The relationship between health risk perception and behavioral intention toward traveling during a health-related crisis is not direct, but indirect via health self-efficacy and attitude about their future trip. The study contributes to understand a cognitive process of tourists’ behavior intention toward traveling in a health-related crisis. Practically, this study’s findings provide tourists, government agencies, tourism marketers, and policy-makers and other tourism stakeholders with important suggestions for tourism recovery during and after the pandemic.

Extending the Risk Perception Attitude Framework to Predict Individuals’ Engagement in Collective Actions Against Cancer

ABSTRACT To identify the psychosocial determinants of individuals’ intention to engage in collective actions against cancer, we extended and tested the risk perception attitude (RPA) framework at the level of social perceptions. The results of a large online survey of Hong Kong citizens (N = 1,005) revealed that perceived societal risk and perceived collective efficacy directly and jointly influenced respondents’ intention to engage in collective actions against cancer, namely donating to cancer charities, volunteering at cancer-prevention organizations, and supporting public policies for cancer prevention. However, the interaction between perceived societal risk and perceived collective efficacy occurred in a direction opposite to the direction in the initial RPA framework. As suggested by the framework, we also categorized individuals into four attitudinal groups based on their perceptions of societal-level risk as well as efficacy and compared their demographic and psychological characteristics. Among the findings, the four groups significantly differed in their perceptions of individual-level risk as well as efficacy, in their family cancer history, and in their intentions to engage in individual-level behaviors to prevent cancer. Altogether, our findings contribute to the literature by extending the RPA framework to individuals’ societal-level perceptions and by providing evidence that the framework can benefit the development of health communication campaigns to promote engagement in collective actions to support cancer prevention.

Intentions to Seek Information about E-Cigarettes: Perceived Risk, Efficacy, and Smoking Identity

While e-cigarette use increases in the US., people’s knowledge about e-cigarettes is limited. Information seeking may influence people’s knowledge about e-cigarettes. Using the risk perception attitude framework and the identity theory, this study examined if U.S. adult current smokers (n = 1,841) differing in perceived efficacy of switching completely to e-cigarettes, perceived risk of cigarette smoking, and smoking identity report different levels of intentions to seek information about e-cigarettes. Results revealed that smokers with high perceived risk of smoking and perceived efficacy about switching completely to e-cigarettes (responsive group) reported strongest intentions to seek information about e-cigarettes (M = 5.41 on a 1–7 scale), followed by the group having low smoking risk perceptions and high e-cigarette efficacy beliefs (proactive group; M = 4.58), the group having high smoking risk perceptions and low e-cigarette efficacy beliefs (avoidance group; M = 3.18), and the group low on both factors (indifference group; M = 2.76). The differences between responsive group and proactive, avoidance, and indifference groups were greater among smokers with high (M diff = 6.14) vs. low (M diff = 5.27) smoking identity. Theoretical and practical implications of the findings are discussed.