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Multiple Risk Study
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This bibliography contains references used in our study of multiple risk. The list includes articles that address risk processing, perception of health risks, risk communication and information seeking, as well as articles addressing behavior change in response to health risks.

Selected Articles on Health and Risk Communication

Avis, N. E., Smith, K. W., & McKinlay, J. B. (1989). Accuracy of perceptions of heart-attack risk - What influences perceptions and can they be changed. American Journal of Public Health, 79(12), 1608-1612.

Barnett, J., & Breakwell, G. (2001). Risk perception and experience: Hazard personality profiles and individual differences. Risk Analysis, 21(1), 171-177.

Cho, Y. H., Keller, L. R., & Cooper, M. L. (1999). Applying decision-making approaches to health risk-taking behaviors: Progress and remaining challenges. Journal of Mathematical Psychology, 43(2), 261-285.

DeNavas-Walt, C., Proctor, B. D., & Hill Lee, C. (2006). Current population reports, P60-229: Income, poverty, and health insurance coverage in the United States: 2004. Washington, DC: U.S. Census Bureau.

Dutta-Bergman, M. J. (2005). Theory and Practice in Health Communication Campaigns: A Critical Interrogation. Health Communication, 18(2), 103-122.

Fowler-Brown, A., Ashkin, E., Corbie-Smith, G., Thaker, S., & Pathman, D. E. (2006). Perception of racial barriers to health care in the rural South. Journal of Health Care For the Poor and Underserved, 17(1), 86-100.

Freimuth, V. (2003). Epilogue to the Special Issue on Anthrax. Journal of Health Communication, 8(4), 148.

Freimuth, V. S., Quinn, S. C., Thomas, S. B., Cole, G. E., Zook, E., & Duncan, T. (2001). African Americans—Views on research and the Tuskegee Syphilis Study. Social Science & Medicine, 54(5), 797-808.

Gerrard, M., Gibbons, F. X., & Reis-Bergan, M. (1999). The effect of risk communication on risk perceptions: The significance of individual differences. Journal of the National Cancer Institute, 25(18), 94.

Griffin, R., Dunwoody, S., & Neuwirth, K. (1999). Proposed model of the relationship of risk information seeking and processing to the development of preventive behaviors. Environmental Research, 80(2), S230-S245.

Griffin, R. J., & Dunwoody, S. (2000). The relation of communication to risk judgment and preventive behavior related to lead in tap water. Health Communication, 12(1), 81-107.

Griffin, R. J., Neuwirth, K., Giese, J., & Dunwoody, S. (2002). Linking the heuristic-systematic model and depth of processing. Communication Research, 29(6), 705.

Johnson, B. B., & Slovic, P. (1995). Presenting uncertainty in health risk assessment: Initial studies of its effects on risk perception and trust. Risk Analysis: An International Journal, 15(4), 485-494.

Kahlor, L., Dunwoody, S., Griffin, R. J., Neuwirth, K., & Giese, J. (2003). Studying heuristic-systematic processing of risk communication. Risk Analysis, 23(2), 355-368.

Kreps, G. L. (2003). The impact of communication on cancer risk, incidence, morbidity, mortality, and quality of life. Health Communication, 15(2), 161-169.

Lindbladh, E., & Lyttkens, C. H. (2003). Polarization in the reaction to health-risk information: A question of social position? Risk Analysis, 23(4), 841-855.

McComas, K. A. (2006). Defining moments in risk communication research: 1996-2005. Journal of Health Communication, 11(1), 75-91.

Michel, S., Jocelyn, R., Claude, F., & Antoine, F. (2005). Risk perception of the “Mad Cow Disease” in France: Determinants and consequences. Risk Analysis, 25(4), 813-826.

Muriel, B., Sophie, B., Sveti, C., & Etienne, M. (2001). Personality Correlates of Risk Perception. Risk Analysis, 21(3), 457-466.

Murray, C. D., & Turner, E. (2004). Health, risk and sunbed use: A qualitative study. Health, Risk & Society, 6(1), 67-80.

Ogata Jones, K., Denham, B. E., & Springston, J. K. (2006). Effects of mass and interpersonal communication on breast cancer screening: Advancing agenda-setting theory in health contexts. Journal of Applied Communication Research, 34(1), 94-113.

Park, E., Scherer, C., & Glynn, C. (2001). Community involvement and risk perception at personal and societal levels. Health, Risk & Society, 3(3), 281-292.

Petts, J., & Niemeyer, S. (2004). Health risk communication and amplification: Learning from the MMR vaccination controversy. Health, Risk & Society, 6(1), 7-23.

Renn, O., Burns, W. J., Kasperson, J. X., Kasperson, R. E., & Slovic, P. (1992). The social amplification of risk: Theoretical foundations and empirical applications. Journal of Social Issues, 48(4), 137-160.

Rimal, R. N., & Real, K. (2003). Perceived risk and efficacy beliefs as motivators of change: Use of the risk perception attitude (RPA) framework to understand health behaviors. Human Communication Research, 29(3), 370-399.

Robert, J. G., Kurt, N., James, G., & Sharon, D. (2002). Linking the heuristic-systematic model and depth of processing. Communication Research, 29(6), 705-732.

Robert, S. A. (1999). Socioeconomic position And health: The independent contribution of community socioeconomic context. Annual Review of Sociology, 25(1), 489-516.

Russell, C. (1999). Living can be hazardous to your health: How the news media cover cancer risks Journal of the National Cancer Institute Monographs, 25, 167-170.

Ruston, A., & Clayton, J. (2002). Coronary heart disease: women's assessment of risk -- a qualitative study. Health, Risk & Society, 4(2), 125-137.

Rutter, D. R., Quine, L., & Albery, I. P. (1998). Perceptions of risk in motorcyclists: Unrealistic optimism, relative realism and predictions of behavior. British Journal of Psychology, 89, 681-696.

Scherer, C. W., & Cho, H. (2003). A social network contagion theory of risk perception. Risk Analysis: An International Journal, 23(2), 261-267.

Settersten, L., & Lauver, D. R. (2004). Critical thinking, perceived health status, and participation in health behaviors. Nursing Research, 53(1 (Print)), 11-18.

Snyder, L. B., Hamilton, M. A., Mitchell, E. W., Kiwanuka-Tondo, J., Fleming-Milici, F., & Proctor, D. (2004). A meta-analysis of the effect of mediated health communication campaigns on behavior change in the United States. Journal of Health Communication, 9, 71-96.

Talosig-Garcia, M., & Davis, S. W. (2005). Information-seeking behavior of minority breast cancer patients: An exploratory study. Journal of Health Communication, 10, 53-64.

Thornton, B., Gibbons, F. X., & Gerrard, M. (2002). Risk perception and prototype perception: Independent processes predicting risk behavior. Personality and Social Psychology Bulletin, 28(7), 986-999.

Trumbo, C. W. (1999). Heuristic-systematic information processing and risk judgment. Risk Analysis, 19(3), 391-400.

Weinstein, N. D., Sandman, P. M., & Roberts, N. E. (1991). Perceived susceptibility and self-protective behavior - A field experiment to encourage home radon testing. Health Psychology, 10(1), 25-33.

Risk Typology

To help us understand how individuals process risks, we attempted to first understand how past researchers have categorized risk. This paper reviews some of the major research that has attempted to determine the different dimensions of risk in order to build a typology of health risks.  

There has been extensive research done on the study of health risks within society (e.g., Blaxter, 1999; Barnett & Breakwell, 2001), however few communication studies focus on multiple health risks and instead focus on a single disease or prevention behavior such as Diabetes or engaging in regular physical activity. Also, no studies that we have found examine the manner in which the poor and near poor in the south process multiple health risks. This is important because individuals have to determine each day what behaviors to engage in or not engage in, and to make judgments about what constitutes a potential health risk based on their assessment of a multitude of health risks and protective behaviors. In order to understand the manner in which individuals process information about multiple health risks, we propose a typology of risks that categorizes health risks and health behaviors, and conceptualizes peoples’ judgments about risk and most importantly health protective behaviors.

Categorizing Risk

There are many ways in which risk may be perceived both by researchers and lay individuals. Risk may be viewed as characteristic of a situation, consequences of a choice, or the manner in which a situation is assessed (Conchar, Zinkhan, Peters, & Olavarrieta, 2004). Blaxter (1999) describes health risks as the likelihood that particular adverse events will occur. Because there are so many perceptions of what risk is and the manner in which it may be interpreted, many researchers have categorized risk in different ways.

Some researchers have suggested that risks should be categorized as voluntary or involuntary (Barnett & Breakwell, 2001). Barnett and Breakwell (2001) suggested that the volitional nature would affect the manner in which an individual would assess risks. Risks are often conceived as an option or choice with alternatives (Fischhoff, Watson, & Hope, 1990), and are studied as something that can be prevented or minimized. However, Barnett and Breakwell (2001) moved beyond the idea that risks are always something preventable when they looked at multiple risks and the individual control over those risks. Similarly, Bouyer, Bagdassarian, Chaabanne, and Mullet (2001) developed ten risk factors that ultimately were categorized as either voluntary or involuntary. However, this form of categorizing risk is much too broad for the current study, but did offer insight into the consideration of volitional control when determining the current conception of risk.

Risks have also been categorized by type or perception of hazard (Lee, Lemyre, Mercier, Bouchard, & Krewski, 2005). Lee et al. (2005) discussed the manner in which individual health belief factors affected the salience of risk perceptions across three categories of hazards. The categories for hazards came from a previous study by Lemyre (as stated in Lee et al., 2005) and were divided into environmental, therapeutic and social hazards. Environmental hazards were risks that related to radiation chemicals or contaminants that are found within the global environment. Therapeutic risks were medical or therapeutic behaviors such as contraceptives, contact lenses, or x-rays. Finally, social hazards related to behaviors that individuals engage in that pertain to lifestyle choices or societal problems such as vehicle accidents, cigarette smoking, or crime and violence.

Finally, one of the typologies that was the most influential to our study was developed by the British Economic and Social Research Council (ESRC). Blaxter (1999) in his article discussing the work done by the ESRC in 1993 describes the manner in which this program conceptualized risk. At that time the ESRC divided risk into three categories: society and risk (e.g., the manner in which decisions impact a larger whole), personal risk (e.g., decision making and uncertainty and risk behaviors), and environmental and technological (e.g., its perception, assessment and reduction) risks. Within each of these three categories they developed subgroups. For the purpose of the current study, the subgroup “personal risks” is most relevant because we want to examine people’s perceptions of and response to risks to their own personal health (versus risks to their community, society or environment).

As Blaxter (1999) presents, the category of personal risk included: behavioral habits, medical risks, accidents, and environment. Behavioral habits pertain to risky activities such as smoking, sun exposure, and sexual behaviors. Medical risks are risks that come with behaviors such as medical treatment, drug prescriptions and pregnancy. Accident/violence risks are those that are associated with situations inherent to sports, driving or being elderly among other activities either recreational or daily routines that could be consider risky. Finally, environment is a category associated to food, genetics or any other individual health risks that are products of the environment. This category could plausibly include natural disasters and bioterrorism as well.

When trying to conceptualize risk for the current study it was made obvious to us the wide range of categories for risk. Although these early typologies of risk helped us to identify the variety of (and categorization of) risks, we discovered that the typologies fail to consider other factors beyond types of risks such as severity, cost, compliance, and with what frequency risk protective behaviors must be performed. In addition, some of the typologies have tendency to describe risky events or activities, rather than focusing on behaviors that might reduce risk or what we will call health protective behaviors. For instance, Blaxter’s (1999) category of medical risks related to prescription drugs describe the risks that are associated with taking prescription drugs rather than the behavior of taking prescription drugs to prevent the risk of future sickness of disease which is the focus of our study. We are concerned with health protective behaviors that individuals can engage in order to minimize or prevent risks.

References

Barnett, J., & Breakwell, G. (2001). Risk perception and experience: Hazard personality profiles and individual differences. Risk Analysis, 21(1), 171-177.

Blaxter, M. (1999). Risk, health, and social research: Lessons from the ERSC programme on risk and human behavior. Health, Risk & Society, 1(1), 11-24.

Bouyer, M., Bagdassarian, S., Chaabanne, S., & Mullet, E. (2001). Personality correlates of risk perception. Risk Analysis, 21(3), 457-466.

Conchar, M. P., Zinkhan, G. M., Peters, C., & Olavarrieta, S. (2004). An integrated framework for the conceptualization of consumers’ perceived-risk processing. Journal of the Academy of Marketing Science, 32(4), 418-436.

Lee, J. C., Lemyre, L., Mercier, P., Bouchard, L., & Krewski, D. (2005). Beyond the hazard: The role of beliefs in health risk perception. Human & Ecological Risk Assessment, 11(6), 1111-1126.

Thompson, W. W., Shay, D. K., Weintraub, E., Brammer, L., Cox, N., Anderson, L. J., et al. (2003). Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA, 289(2), 179-186.

Centers for Health and Risk Communication

Harvard Center for Cancer Prevention -- http://www.yourdiseaserisk.harvard.edu/
Export Health, University of Pittsburgh -- http://www.exporthealth.pitt.edu/
University of Maryland Risk Communication Center -- http://www.comm.riskcenter.umd.edu/
The Health Communication Unit at the Centre for Health Promotion, University of Toronto:-- http://www.thcu.ca/
University of Pittsburgh School of Public Health Center for Public Health Preparedness -- http://www.cphp.pitt.edu/upcphp/certificate.htm
Michigan State Health and Risk Communication Center -- http://hrcc.cas.msu.edu/
Risk Perception and Communication, Carnegie Mellon University -- http://sds.hss.cmu.edu/risk/Home.htm
Center for Risk Communication – http://www.centerforriskcommunication.com/home.htm
Institute for Risk Analysis and Risk Communication, Washington University -- http://depts.washington.edu/irarc/
John Hopkins Center for Public Health Preparedness -- http://www.jhsph.edu/preparedness/

Southern Poverty and Health

UGA Carl Vinson Institute of Government -- http://www.cviog.uga.edu/services/research/poverty/
UGA’s Initiative on Poverty and the Economy -- http://www.poverty.uga.edu/maps/
National Poverty Center -- http://www.npc.umich.edu/
Institute on Research and Poverty -- http://www.irp.wisc.edu/research/health.htm
US Census Bureau Poverty Data -- http://www.census.gov/hhes/www/poverty/poverty.html
National Health and Nutrition Examination Survey -- http://www.cdc.gov/nchs/nhanes.htm
Health Information National Trends Survey -- http://cancercontrol.cancer.gov/hints/
CDC’s Behavioral Risk Factor Surveillance System -- http://www.cdc.gov/BRFSS/

Risk Communication

Risk Communication @ Pandemic flu.gov -- http://www.pandemicflu.gov/rcommunication/
Society of Risk Analysis -- http://www.sra.org/
CDC Emergency and Risk Communication -- http://www.bt.cdc.gov/erc/
CDCynergy -- http://www.bt.cdc.gov/erc/erc.asp
National Cancer Society Risk Communication Bibliography -- http://dccps.nci.nih.gov/DECC/riskcommbib/
The Peter Sandman Risk Communication Site – http://www.psandman.com/

 

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