Risk Perception Attitude Framework Research Articles

Understanding Health Information Seeking: A Test of the Risk Perception Attitude Framework

The authors used the Risk Perception Attitude framework, which is grounded in the Extended Parallel Process Model, to predict people's intentions to seek health information. In an online survey, 689 participants recruited from a crowdsource website were queried about their anticipated health information seeking, perceived risk, and efficacy in response to four scenarios pertaining to hypertension, hypercholesterolemia, alcohol dependence, and diabetes. Each participant was categorized for each scenario as responsive (higher risk, higher efficacy), avoidant (higher risk, lower efficacy), proactive (lower risk, higher efficacy), or indifferent (lower risk, lower efficacy). As predicted, responsive individuals were more likely to seek information than avoidant individuals, but only in three of the four scenarios. Also as expected, there was no difference between proactive and indifferent individuals’ likelihood of seeking health information for any scenario. Risk and efficacy, while significant predictors of anticipated health information seeking, left much of the variance unexplained. An analysis of the reasons for information seeking and nonseeking among nonconforming cases suggests that a wider range of influences on health information seeking should be investigated, including curiosity, prior knowledge, social expectations, and situational norms.

Men’s Intentions to Engage in Behaviors to Protect Against Human Papillomavirus (HPV): Testing the Risk Perception Attitude Framework

Guided by the risk perception attitude framework (RPA), this study examined men’s perceptions of risk and efficacy beliefs as predictors of their intentions to engage in self-protective behaviors. The results of multiple regression analyses did not provide support for the RPA prediction that efficacy beliefs moderate the relationship between risk perceptions and self-protective behavior. However, the results provide support for the main effects of risk and efficacy on all four behavioral intentions examined (i.e., Internet information seeking, communication with a health provider, HPV vaccination, and condom use). Risk and efficacy were positively related to (and significant individual predictors of) all four behavioral intentions. Scholarly and practical implications of these findings are discussed.

The Influence of Risk Perceptions and Efficacy Beliefs on Leisure-Time Physical Activity during Pregnancy

Pregnancy risk perceptions and physical activity efficacy beliefs may facilitate or impede pregnancy leisure-time physical activity (LTPA). According to the Risk Perception Attitude Framework (RPA), these psychosocial factors may have an interactive effect on behavior. PURPOSE: To determine the separate and joint influence of pregnancy risk perceptions and LTPA efficacy beliefs on LTPA behavior among pregnant women. METHODS: Pregnant women (n=302) completed a survey which contained questions on LTPA beliefs and behavior, as well as pregnancy risk perceptions with respect to the health of the unborn baby. Median splits were used to categorize women as high/low for their pregnancy risk perceptions and LTPA efficacy beliefs for both moderate and vigorous LTPA. These variables were then combined to create four RPA attitudinal groups: Responsive (High Risk+High Efficacy), Proactive (Low+High), Avoidant (High+Low), and Indifferent (Low+Low). Moderate LTPA was dichotomized as meeting guidelines [moderate LTPA ≥150 min/week] or not. Vigorous LTPA was dichotomized as performing any [vigorous LTPA >0 min/week] or not. Chi-square and logistic regression analyses were used to examine relations between RPA attitudinal groups and LTPA participation. Hierarchical logistic regression was used to examine the joint influence of pregnancy risk perceptions and LTPA efficacy beliefs on pregnancy LTPA. RESULTS: A total of 82 women (27.2%) met the moderate LTPA guidelines and 90 women (30.1%) performed any vigorous LTPA. Responsive and proactive pregnant women (those with high efficacy) were most likely to meet the moderate LTPA guidelines and participate in any vigorous LTPA. Hierarchical logistic regression did not reveal an interactive effect of pregnancy risk perceptions and LTPA efficacy beliefs for meeting moderate LTPA guidelines (β=0.94, CI=0.66-1.36) or any vigorous LTPA participation (β=1.41, CI=0.86-2.29). CONCLUSIONS: LTPA efficacy beliefs are important in facilitating greater levels of pregnancy LTPA. Significant interactive effects between pregnancy risk perceptions (with respect to the health of the baby) and LTPA efficacy beliefs on LTPA participation were not found. Health promotion efforts should focus on increasing LTPA self-efficacy to increase rates of participation among pregnant women.

Testing the Risk Perception Attitude Framework in the Context of Texting While Driving

Texting while driving has become an increasingly prevalent health threat, and research is needed to identify important elements of persuasive messages aimed at reducing its occurrence. The current study tested the risk perception attitude framework (Rimal & Real, 2003) with the outcomes of issue salience, behavioral intentions, and behavioral effects (i.e., a behavioral proxy measure) of texting while driving. Results revealed that risk perceptions and efficacy beliefs increased issue salience and behavioral intentions, and efficacy beliefs moderated the relationship between risk perceptions and behavioral effects. These findings are expected to help inform future intervention efforts to inhibit texting while driving.

Explaining Public Support for Climate Change Mitigation Policies – An Analytical Framework

The literature has identified many important drivers of climate change mitigation policy support behaviour (PS), such as perceived policy effectiveness (PE) and perceived adverse impacts of climate change (PI). However, it rarely explains the mechanism by which PE drives PS. Even though the literature warns against the over-use of PI in climate change communication, which is commonly known as the “fear appeal” approach, an explaining theoretical framework is seldom provided. Moreover, the literature also often neglects the extent to which the fundamental characteristics of mitigation initiatives affect policy preferences. This limitation derives from inadequate examination of the nature of the policies, as was as the deeper factorial structures of the behaviour’s determinants. Synchronising the social dilemma literature with major theories in the field such as the Theory of Planned Behaviour, the Risk Perception theory, the Extended Parallel Process Model, and the Risk Perception Attitude framework, this paper proposes an analytical framework that helps explain the variation in PS across the policies’ characteristics. The framework also suggests a mediating mechanism through which PE drives PS, and a moderating perspective, which may help theoretically verify the “fear appeal” caution. This paper also suggests that in addition to effectiveness, perceived policy feasibility should be included as an important aspect of individuals’ policy evaluation to explain PS. Discussions and further research suggestions are also offered.

Segmenting by Risk Perceptions: Predicting Young Adults’ Genetic-Belief Profiles with Health and Opinion-Leader Covariates

With a growing interest in using genetic information to motivate young adults’ health behaviors, audience segmentation is needed for effective campaign design. Using latent class analysis, this study identifies segments based on young adults’ (N = 327) beliefs about genetic threats to their health and personal efficacy over genetic influences on their health. A four-class model was identified. The model indicators fit the risk perception attitude framework (Rimal & Real, 2003), but the covariates (e.g., current health behaviors) did not. In addition, opinion leader qualities covaried with one profile: Those in this profile engaged in fewer preventative behaviors and more dangerous treatment options, and also liked to persuade others, making them a particularly salient group for campaign efforts. The implications for adult-onset disorders, like alpha-1 antitrypsin deficiency, are discussed.

Smoker identity among social smokers: theory-based approaches for anti-smoking interventions

A large number of college smokers refuse to self-identify as smokers, instead referring to themselves as social smokers. With little or no information on how social smokers perceive risks and levels of efficacy related to smoking cessation, designing effective anti-smoking campaigns may be problematic. Based on the theoretical underpinning of the Risk Perception Attitude Framework, we investigated the impact of perceived risks and self-efficacy on the intention to quit smoking among social smokers and compared the findings to those who self-identify as smokers (i.e. admitters) and non-smokers (i.e. deniers). An online survey was conducted targeting college students who had smoked in the past 30 days. Of the 414 total participants, 111 self-identified as social smokers. Results show that deniers were no more willing to quit than admitters albeit with a greater self-efficacy. Deniers also tended to underestimate the risks of smoking and possessed greater feelings of self-efficacy. Admitters, in contrast, were higher in perceived risk but lower in self-efficacy. In addition, the cognitive paths to quit smoking via perceived risks and assessment of self-efficacy were compared between deniers and admitters. The importance of considering smoking identity is discussed and practical implications for anti-smoking campaigns are provided.

Segmenting publics for developing more strategic anti-drinking campaigns based on the risk perception attitude framework

Segmenting publics for developing more strategic anti-drinking campaigns based on the risk perception attitude framework

Using a validated health promotion tool to improve patient safety and increase health care personnel influenza vaccination rates

This study employed the risk perception attitude (RPA) framework to determine whether health care personnel (HCP) influenza-related risk perceptions and efficacy beliefs could be used to segment individuals into meaningful groups related to vaccination uptake, absenteeism, and patient safety beliefs. After pilot interviews, a questionnaire was administered to 318 hospital-based HCP (80%) andnonclinical support staff (20%) in Lexington, KY, in 2011. Follow-up interviews were conducted with 29 respondents. Cluster analysis was used to create 4 groups that correspond to the RPA framework: responsive (high risk, strong efficacy), avoidance (high risk, weak efficacy), proactive (low risk, strong efficacy), and indifference (low risk, weak efficacy). A significant association was found between membership in 1 or more of the 4 RPA groups and the 3 study variables of interest: influenza vaccination uptake (F7,299=2.51, P<.05), influenza-related absenteeism (F7,269=3.6, P<.001), and perceptions of patient safety climate (F7,304=6.21, P<.001). A subset of respondents indicated the principal reasons for not getting vaccinated were "had one before and got sick anyway," "concerned about vaccine safety," and "no convenient time." In follow-up interviews, HCP indicated that employee vaccinations were altruistic, increased herd immunity, and important for patient safety. The RPA framework is a valid health promotion tool for improving patient safety, targeting specific groups for interventions, and improving HCP influenza vaccination rates.

Predicting Human Papillomavirus Vaccine Intentions of College-Aged Males: An Examination of Parents’ and Son's Perceptions

Objective: To examine male students’ and their parents’ human papillomavirus (HPV) vaccine communication in relation to males’ willingness to discuss the vaccine with their health care provider and the likelihood of being vaccinated. Participants: Dyads (n = 111) of students and parents. Methods: Participants completed a HPV vaccine survey based on the risk perception attitude framework in 2009. Results: Male students’ perceived susceptibility for HPV and self-efficacy to talk to their provider were directly related to their intention to discuss the HPV vaccine, and their intention was directly related to their likelihood of being vaccinated. Parents’ perceived self-efficacy to talk to their son and response efficacy of the vaccine were directly related to their intention to talk to their son; however, parents’ intention was not related to the likelihood of their son being vaccinated. Conclusions: College males may benefit from HPV vaccine educational programs that include communication skills training to discuss the HPV vaccine with their parents.

Information Seeking About Global Climate Change Among Adolescents: The Role of Risk Perceptions, Efficacy Beliefs, and Parental Influences

Global climate change is likely to have significant impacts on public health. Effective communication is critical to informing public decision making and behavior to mitigate climate change. An effective method of audience segmentation, the risk perception attitude (RPA) framework, has been previously tested with other health behaviors and classifies people into 4 groups on the basis of their perceptions of risk and beliefs about personal efficacy. The 4 groups—indifference (low risk, weak efficacy), proactive (low risk, strong efficacy), avoidance (high risk, weak efficacy), and responsive (high risk, strong efficacy)—are hypothesized to differ in their self-protective behaviors and in their motivations to seek information. In this article, we extend the RPA framework in two ways. First, we use it at the household level to determine whether parental classifications into the 4 groups are associated with their teenage children's classification into the same 4 groups. Second, we predict adolescent information seeking behaviors on the basis of their and their parents' membership in the 4 RPA groups. Results (N = 523 parent–adolescent pairs) indicated that parental membership in the 4 RPA groups was significantly associated with children's membership in the same 4 groups. Furthermore, the RPA framework was a significant predictor of adolescent information seeking: Those in the responsive and avoidance groups sought more information on climate change than the indifference group. Family communication on global warming was positively associated with adolescents' information seeking. Implications for interventions are discussed.

Cognitive and Emotional Health Risk Perceptions Among People Living in Poverty

Many theories of risk perception and health behavior examine cognitive dimensions of risk (i.e., perceived susceptibility or severity) but not emotional dimensions. To address this gap, the authors examined the emotional component of risk perception (as worry) and its relation to cognitive assessments of risk, self-efficacy and response efficacy, and health protective action. Although people in poverty are at high risk for many health conditions, little is known about how concerned they are about these conditions or how their risk perceptions influence health actions. African Americans and Whites with incomes ≤$35,000 were surveyed (N = 431). Participants reported their worry level for 10 health risks. Among their highest worry risks, they identified the risk they took the most action and the risk they took the least action to prevent. Worry was low or moderate for each health risk and chronic conditions were of the most concern. For high- and low-action risks, response efficacy moderated the relation between cognitive risk perception and health protective action. For low-action risks, decisions to act were affected independently by cognitive and emotional responses. The results support the Risk Perception Attitude Framework and indicate the importance of using cognitive and emotional dimensions of risk in behavior change models.

How Much Knowledge Can They Gain? Women's Information Behavior on Government Health Websites in the Context of HIV/AIDS Prevention

Using a theoretical framework extended from Rimal and Real’s (2003) Risk Perception Attitude framework, this research examines women’s information behavior, specifically information finding and reaction to information, on government health websites in the context of HIV/AIDS prevention. In the empirical study, think aloud and structured individual interview were used to collect data from 40 female university students in the U.S. in their completion of an information seeking task and an interview. Factors that influence women’s information finding and reaction to information were identified. This research challenges and extends Rimal and Real’s (2003) Risk Perception Attitude framework by proposing an Extended Risk Perception Attitude framework. This research also exemplifies Gupta’s (2000) categories of social construction of gender and sexuality in the HIV/AIDS discourse, and adds new evidence that proves their validity. In addition, this research enriches the literature in health-related information behavior by switching the research focus to other information behaviors than information seeking.

Use of the Risk Perception Attitude Framework for Promoting Breast Cancer Prevention

The risk perception attitude (RPA) framework classifies people into 4 groups based on their perceptions of risk and personal efficacy: responsive (high risk, high efficacy), avoidance (high risk, low efficacy), proactive (low risk, high efficacy), and indifference (low risk, low efficacy). This study tested the central propositions from the RPA framework among a group of immigrant Indian women (N = 413) in the Washington, DC area in their propensity to pay attention to breast cancer information and engage in self‐exams and clinical screening. Self‐efficacy and knowledge about breast cancer were consistent predictors of these outcomes. Use of the RPA framework explained 16% to 27% of the variance. Implications for breast cancer prevention campaigns are discussed.

Audience Segmentation as a Social-Marketing Tool in Health Promotion: Use of the Risk Perception Attitude Framework in HIV Prevention in Malawi

We sought to determine whether individuals' risk perceptions and efficacy beliefs could be used to meaningfully segment audiences to assist interventions that seek to change HIV-related behaviors. A household-level survey of individuals (N=968) was conducted in 4 districts in Malawi. On the basis of responses about perceptions of risk and beliefs about personal efficacy, we used cluster analysis to create 4 groups within the risk perception attitude framework: responsive (high risk, strong efficacy), avoidance (high risk, weak efficacy), proactive (low risk, strong efficacy), and indifference (low risk, weak efficacy). We ran analysis of covariance models (controlling for known predictors) to determine how membership in the risk perception attitude framework groups would affect knowledge about HIV, HIV-testing uptake, and condom use. A significant association was found between membership in 1 or more of the 4 risk perception attitude framework groups and the 3 study variables of interest: knowledge about HIV (F8, 956=20.77; P<.001), HIV testing uptake (F8, 952=10.91; P<.001), and condom use (F8, 885=29.59; P<.001). The risk perception attitude framework can serve as a theoretically sound audience segmentation technique that can be used to determine whether messages should augment perceptions of risk, beliefs about personal efficacy, or both.

Extending the Purview of the Risk Perception Attitude Framework: Findings from HIV/AIDS Prevention Research in Malawi

The risk perception attitude (RPA) framework posits that efficacy beliefs moderate the relationship between risk perception and health outcomes. To extend the purview of the theory, this central hypothesis was tested in the context of HIV/AIDS-prevention behaviors. Data (N = 890) were collected from 8 districts in Malawi in southern Africa as part of a baseline research effort to obtain benchmark measures on key behavior-change indicators. Results pertaining to 2 behaviors, use of condoms and remaining monogamous, are reported in this study. Relationships between risk perception and behavioral intentions were not significant, but those between efficacy beliefs and behavioral intentions were. Furthermore, efficacy beliefs were found to moderate the relationship between risk perception and intentions to remain monogamous, but not between risk perceptions and intentions to use condoms. The model was able to explain approximately 40% of the variance in intentions to use condoms, and 19% of the variance in intentions to remain monogamous. Implications for health campaigns, particularly the need to strengthen efficacy beliefs and the need to be careful in enhancing risk perceptions without simultaneously strengthening efficacy beliefs, are also discussed.

The Role of Risk, Efficacy, and Anxiety in Smokers' Cancer Information Seeking

Using the risk perception attitude (RPA) framework and the 2005 Health Information National Trends Survey data, this research investigated the role of perceived personal risk, perceived comparative risk, response efficacy, communication efficacy, and anxiety in smokers' active cancer information seeking. The RPA predictions on the interactions between perceived personal risk and the two efficacy measures were not supported. Perceived personal risk and response efficacy were associated with cancer information seeking both directly and through the mediation of anxiety. Optimistic comparative risk perceptions were associated with less anxiety and were found to moderate the relationship between perceived personal risk and cancer information seeking. Surprisingly, communication efficacy emerged as a negative predictor of cancer information seeking. Theoretical and practical implications of these findings are discussed.

Information Seeking and Workplace Safety: A Field Application of the Risk Perception Attitude Framework

Communication theory is ideally suited to advance systematic forms of knowledge about workplace safety. The focus of this research is to examine workplace safety using health communication theory and research. A field study using a random sample of production workers (n=645) in a manufacturing organization was conducted, to investigate individuals’ risk perception and efficacy beliefs and to validate the predictions of the risk perception attitude framework. Results were consistent with the theory, as risk and efficacy jointly predicted safety behavior, behavioral intentions, and safety information-seeking intentions. Given a particular level of risk, those with greater efficacy beliefs displayed more positive safety outcomes than those with lower efficacy beliefs. The responsive group (high risk, high efficacy) reported safer outcomes than the avoidant group (high risk, low efficacy) and the proactive group (low risk, high efficacy) reported safer outcomes than the indifferent group (low risk, low efficacy). This theoretical frame provides practical directions as to what shapes the safety behaviors and communication patterns of workers in dangerous jobs and offers insights for safety information-seeking and workplace safety.

Nutrition-Related Cancer Prevention Cognitions and Behavioral Intentions: Testing the Risk Perception Attitude Framework

This study tested whether the risk perception attitude framework predicted nutrition-related cancer prevention cognitions and behavioral intentions. Data from the 2003 Health Information National Trends Survey were analyzed to assess respondents' reported likelihood of developing cancer (risk) and perceptions of whether they could lower their chances of getting cancer (efficacy). Respondents with higher efficacy were more likely to report that good nutrition can prevent cancer, and they reported more preventive dietary changes, as compared to respondents with lower efficacy. Respondents with higher efficacy were more likely to report intentions to change their diets to prevent cancer, and they reported more preventive dietary changes to their own diets but only at higher levels of risk. Results suggest that to improve cognitions about the role of nutrition in cancer prevention, interventions should target cancer prevention efficacy; however, to increase intentions to change nutrition behaviors, interventions should target efficacy and risk perceptions.

The Role of Anxiety in Seeking and Retaining Risk Information: Testing the Risk Perception Attitude Framework in Two Studies

Despite the importance of health information seeking, not all people engage in such behaviors, especially when thinking about the disease is distressing. The focus of this paper is to examine the antecedents of information seeking and retention. Based on individuals’ risk perception and efficacy beliefs, the risk perception attitude framework is used to formulate four groups: responsive (high risk, high efficacy), avoidance (high risk, low efficacy), proactive (low risk, high efficacy), and indifference (low risk, low efficacy). In Study 1, a 2 (risk) × 2 (efficacy) between-subjects experiment, participants’ perceived risk to skin cancer and skin cancer–related efficacy beliefs were induced to determine their information seeking, retention, and intentions to engage in future seeking. The responsive group, as predicted, was associated with the most information-seeking behaviors and information-seeking intentions. The avoidance group, however, sought information but exhibited the lowest retention scores. These results were used to derive two predictions—the incredulity hypothesis and the anxiety-reduction hypothesis—that were then tested in Study 2. Study 2, also a 2 (risk) × 2 (efficacy) between-subjects experiment dealing with diabetes, found support for the anxiety-reduction hypothesis, which argues that the high-risk, low-efficacy group experiences more anxiety, which leads to high motivations to seek, but lower ability to retain information.