Breast Cancer and Environment Pre-Conference

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Strategic Risk Communication Involving
Environmental Health Issues

• Breast Cancer and Environment Pre-Conference
• November 8, 2005
• Michigan State University, Lansing, MI
• Katherine McComas, PhD
• Department of Communication
• Cornell University, Ithaca, NY

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What is Risk?

• things, forces, or circumstances that pose
  danger to people or to what they value (Stern
  Fineberg, 1996, p. 215)
• It encompasses subjective and objective qualities
• Risk judgments, to some degree, are by-products
  of social, cultural, and psychological influences
  (Slovic, 1999)

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What is Risk Communication?

• An iterative process among scientists and
  non-scientists about the assessment,
  characterization, and management of risk.
• Includes purposeful and unintentional messages
  about risk,
• Is multi-directional,
• Encompasses verbal and nonverbal cues, and
• Occurs at personal, group, organizational,
  community, and societal levels.

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• Risk communication enters our lives in a
  multitude of forms, sometimes part of the imagery
  of advertising, sometimes a local corporations
  formal statement, or its failure to say anything,
  sometimes a multi-volumed and impenetrable
  technical risk assessment
• (Kasperson Palmlund, 1987, as cited in Plough
  Krimsky, 1987)

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The Challenge of Risk Communication

• How do we communicate complex science-based
  health or environmental risk information to help
  audiences make the best decisions?

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The Rub

• No matter how accurate it is, risk information
  may be misperceived or rejected if those who give
  information are unaware of the complex,
  interactive nature of risk communication and the
  various factors affecting the reception of the
  risk message.
• (Fessenden-Raden et al., 1987, p. 100)

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Premise

• The manner by which information is provided,
• the structure of arguments,
• the persuasive nature of the message,
• the sources used, and
• the nature of the risk
• all influence audience response to environmental
  health risk messages.

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Questions to Consider

• How complex is the information?
• What if the science is uncertain?
• Are unintentional risk messages also being sent?
• Are there multiple messengers?
• Do some messages conflict with others?
• What are the media saying?

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Mass Media

• If most people get most of their information from
  the mass media, what are the media saying?
• One study found that articles in womens
  magazines discussing breast cancer risks tended
  to report incorrect or incomplete information
  (Marino Gerlach, 1999)

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Effective Message Design

• To communicate risk and design effective
  messages, it is imperative to understand how
• lay audiences process understand alternative ways
  of characterizing environmental health risk
  assessments, and
• the role of message structure in influencing
  perceptions and behaviors.

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Audience Characteristics

• Past experiences with the topic and information
  sources
• Prior knowledge of the topic
• Health of the individual and family members
• Where relevant, attitudes toward the organization
  viewed responsible for the risk
• Culture
• Risk perceptions

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• In the face of scientific information, why do
  people behave irrationally?

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What Do You Fear Most?

• Driving?
• Smoking?
• Flying?
• Eating?
• Boating?
• Guns?
• Alcohol?
• Lightning?
• Big Trucks?
• Flu?
• Lightening?

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Annual Deaths/Risk

• Smoking? (435,000 deaths)
• Eating? (365,000 deaths-diet and inactivity)
• Alcohol? (85,000 deaths)
• Driving? (42,000 deaths)
• Flu? (36,000 deaths)
• Guns? (29,000 deaths)
• Big Trucks? (5,000 car-truck deaths)
• Boating? (1,643 deaths)
• Flying? (176 deaths)
• Lightening? (43 deaths)

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Some Factors Influencing Risk Perceptions

• Can I see it?
• Will I know if Im exposed?
• Are the effects immediate?
• Do scientists know and understand the risks?
• Can I control my exposure?
• Can I easily reduce my exposure

• Is my exposure voluntary?
• Is it a dreaded risk?
• Are the risks borne equally or fairly?
• Does it pose a risk to future generations?
• Are the risks decreasing or increasing?
• (Slovic, 2000)

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Why Does It Matter?

• Understanding how people evaluate risk may help
  risk communicators predict how concerned people
  may be about a risk.
• Under some circumstances, risk communicators may
  be able to lessen unnecessary concern by
  emphasizing certain actions that people can take,
  for example, to reduce or control their exposure
  to a risk.

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Affect and Risk Judgments

• People judge risk based not only on what they
  think about it, but also on what they feel about
  it.
• When people associate positive feelings with the
  activity, they view it as less risky, and vice
  versa.
• When people worry more, they are more likely to
  seek information.
• (Slovic, 1999 Griffin et al., 1999)

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Why Does It Matter?

• Emotions can override other considerations.
• May help to explain gender and age-related
  differences in risk perceptions.
• May help to explain why vivid language,
  narratives, or affective-laden imagery strongly
  influence peoples reactions to risk.
• (Loewenstein, 2001)

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Optimistic Bias

• When asked to rate their chances of being harmed
  or experiencing a positive event, people tend to
  rate their chances as above or below average.
• So, why is this called unrealistic optimism?
• If these beliefs were not biased, in a
  representative sample, claims of being below
  average risk, for instance, would be balanced by
  claims of being above average risk.
• (Weinstein, 1989)

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Why Causes Optimistic Bias?

• People compare themselves to an incorrect norm.
• People tend to have stereotypes in mind when they
  think about who is usually at risk from
  something. If they do not fit this stereotype,
  then they will downplay the likelihood of the
  event happening to them.
• People interpret risk information in a
  self-serving manner.
• People employ ego-defensive mechanisms to
  downplay their risks.
• People believe they have more control over a
  situation than they really do.

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Limiting Optimistic Bias

• When comparing our chances of being exposed to a
  risk to someone elses, the more like us that
  someone else is, the less we have unrealistic
  optimism.
• When we perceive less control over our exposure
  to risk, or view this exposure as less voluntary,
  unrealistic optimism decreases.
• Amount of information people are exposed to about
  a risk, and how salient or meaningful that
  information is to them personally can influence
  optimistic biases.
• Personal exposure to a risk can reduce
  unrealistic optimism.

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Why Does It Matter?

• Unrealistic optimism may hinder efforts to
  promote risk decreasing behavior.
• People do not think they are at risk or that the
  risks pose much danger to their health and safety.

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Trust and Source Credibility

• To what extent do individuals perceive the source
  as trustworthy and/or credible?
• Can depend on perceived shared values (Siegrist
  et al., 2001)
• Also influenced by sources perceived
• Openness
• Caring/Concern
• Bias
• Fairness
• Expertise
• (Meyer, 1988)

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Why Does It Matter?

• When individuals distrust the source, they
  distrust the information.
• They also often perceive the risks as more
  severe.

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When Should Risk Communication Occur?

• Should we wait until were certain?
• Proactive vs. reactive risk communication

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Proactive Risk Communication

• Calls attention to a risk issue, both potential
  and existing, suggests the agenda for discussion,
  and provides mechanisms for information exchange
• Disadvantages
• May alert people to something of which they are
  not aware
• Advantages
• May alert people to something of which they are
  not aware
• May allow for a much more meaningful discussion
  of risk
• May generate more balanced discussion
• (Scherer, 1991)
• Can increase trust

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Reactive Risk Communication

• Does not call attention to a particular risk but
  waits until there is already considerable public
  and media attention about a risk issue
• Advantage
• Allows the public to vent about the issue
• Disadvantages
• Science may be less relevant when issues become
  highly emotionally charged
• Places communicator in defensive position
• People may not believe information that is
  delayed
• People may not have information they need to
  protect their or their familys health and safety

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Developing Risk Messages

• Now that youve decided to communicate, what
  should your message include?

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Message Strategies

• Persuasive
• Balanced
• Narrative
• Dialectical

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(1) Persuasive Approaches

• Typically one-sided approach seeking to convince
  audience to change attitudes and behaviors in a
  particular direction.
• Sometimes referred to as advocacy approaches.
• Key factors influencing persuasion include source
  characteristics (e.g., credibility), message
  design, and audience characteristics.
• Work best where there is scientific consensus and
  social agreement about risks.
• (Fischhoff, 1999)

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(2) Balanced Models

• Typical of mass media coverage.
• Often presents multiple perspectives or opinions
  but stops short of advocating a particular
  position
• thus frequently leaving audiences without
  specific behavioral guidance.
• Presents all sides as equally as possible and
  then lets individuals make up their mind.
• Sometimes referred to as journalistic approach
  (minus the editorializing).

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(3) Narrative Approaches

• Stories can personalize the risk, making it seem
  more real
• Media usually highlight someones story
• Narrative factors guide audience reaction to the
  messages
• Stories help disseminate shared values, which may
  promote trust
• (Greene Brinn, 2003 Siegrist et al., 2001)

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(4) Dialectical Models

• Uses a series of questions and answers to probe
  through possibilities and weigh contradictory
  facts and opinions with a view to their
  resolution.
• Does not advocate a particular position but tries
  to equip audiences with tools necessary to
  evaluate information.
• Interactive techniques used to involve the public
  in environmental decision making employ similar
  strategies.
• (Scherer et al., 1999)

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Questions to Consider

• When choosing a message strategies, risk
  communication efforts should ask
• Who is the target audience?
• What is the objective of the message?
• Provide information
• Promote more critical thinking or informed
  judgments about risk
• Promote attitude or behavior change
• Build trust among communicators and audience

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Additional Message Elements

• Risk severity
• More severe risks gain more attention, but can go
  too far
• Efficacy statements
• When people believe they have the ability to
  change, and that the change will indeed help,
  they are more likely to adopt protective behavior
  (Witte, 1994).
• Comparisons
• Work best when source is trusted and comparisons
  are within the same family of risks (Johnson
  Chess, 2003)
• Visuals
• A strong communication tool when used
  thoughtfully (Lipkus Hollands, 1999)

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Where Should Risk Communication Occur?
Format Channel Advantages Disadvantages
One-on-one House calls, healthcare appointments, internal meetings Direct interaction, Greater control over message and outcomes Limited audience reach
Public Forums Seminars, conferences, industry and public meetings, workshops Direct interaction, Greater control over message Limited audience reach, Less control over outcomes
Mass Mediated (Non-specialized media) Paid ads, press releases, media interviews Wide audience reach Less control over message (except paid ads), one-way, Difficulty assessing effectiveness
Electronic Web sites, 1-800 hotlines, listservs, broadcast emails Wide audience reach, can be interactive Difficultly assessing effectiveness, can be one-way
Direct Mail Newsletters, business correspondence, flyers Wide audience reach Difficulty assessing effectiveness, one-way
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References

• Fessenden-Raden, J., Fitchen, J. M., Heath, J.
  S. (1987). Providing Risk Information in
  Communities Factors Influencing What Is Heard
  and Accepted. Science, Technology, and Human
  Values, 12(3 4), 94-101.
• Fischhoff, B. (1999). Why (cancer) risk
  communication can be hard. Journal of the
  National Cancer Institute Monographs, 25, 7-13.
• Greene, K., Brinn, L. S. (2003). Messages
  influencing college women's tanning bed use
  Statistical versus narrative evidence format and
  a self-assessment to increase perceived
  susceptibility. Journal Of Health Communication,
  8(5), 443-461.
• Griffin, R. J., 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.
• Johnson, B. B., Chess, C. (2003). How
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  standards and emission limits? Risk Analysis,
  23(5), 999-1007.
• Lipkus, I. M., Hollands, J. G. (1999). The
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• Loewenstein, G. F., Weber, E. U., Hsee, C. K.,
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• Marino, C., Gerlach, K. K. (1999). An analysis
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• Meyer, P. (1988). Defining and measuring
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• Scherer, C. (1991). Strategies for communicating
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• Scherer, C. W., McComas, K. A., Juanillo, N.,
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• Siegrist, M., Cvetkovich, G. T., Gutscher, H.
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• Weinstein, N. D. (1989). Optimistic biases about
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• Witte, K. (1994). Fear Control And Danger Control
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