Danger Ahead: Risk Communication Leads to Healthier Living

Psychological research shows efforts to change people's judgments about the risks associated with health-related behaviors can successfully change those behaviors.

Findings

Judgments about the likelihood of contracting a disease are directly related to willingness to act in ways that reduce risk. Moreover, risk judgments are related to worry, and both factors increase motivation to protect oneself from health threats. For example, in a review of studies on breast cancer screening, psychologist Kevin McCaul, PhD, and colleagues found that women who think they are likely to get breast cancer some day are more likely to have a mammogram than are women who think that they are unlikely to get breast cancer.

Similarly, Kim Witte, PhD, and her associates have demonstrated that interventions affecting both risk judgments and fear produce self-protective behavior. For example, they directed messages about skin cancer to college students in the southwestern United States and found that scary messages about the awful things that can happen to one's skin successfully promote plans to reduce sun exposure, especially when the message also convinced students that sun-avoidance was very likely to reduce the negative effects of sun exposure.

In a completely different domain, psychologist Neil Weinstein, PhD, and his colleagues at Rutgers University sent letters and videos to nearly 2,000 homeowners in Columbus, Ohio. One video explained that a high risk of radon problems existed in area homes, and this message encouraged homeowners who were undecided about testing their home to decide to do so. Results of the study show that the risk messages were effective in getting people to move a step closer to taking action, especially prompting those who were undecided about testing to decide to get their homes tested for radon.

Most importantly, research has shown that efforts to change people's judgments about the risks associated with many, very different health-related behaviors can successfully change those behaviors. For example, in one experiment, adult daily smokers watched a videotape showing interviews with smokers and ex-smokers who had experienced different smoking-related illnesses. The videotape increased the viewers' risk judgments, their motivation to quit smoking, and their likelihood of quitting smoking over the ensuing 3 months.

Contrary to the widely held belief that adolescents think that they are invulnerable, researchers at Iowa State University and the University of California San Diego have shown that risk messages can be successful in changing the behavior of young people. Psychologist Frederick Gibbons, PhD, and his colleagues showed college students photographs of their faces using a filter that revealed the skin damage that they had already sustained from the sun. They also gave them information about the risks of sun exposure, such as premature skin wrinkling and skin cancer. This intervention was successful in decreasing the use of tanning booths over the next month.

Significance

These findings support the efforts of health professionals to remind patients about their risk of disease and suggest that the increased levels of self-protective behaviors that people are likely to adopt offset the minor worries that might accompany such reminders. The findings also suggest, though, that people who are responsible for explaining health threats to the public need to do so carefully, making sure that the behaviors they recommend (cancer screening or increased exercise, for example) actually will reduce the health risks that people are trying to avoid.

Practical Application

Health professionals are now applying these findings in public education programs. Health educators in North Dakota created a video intended to increase personal vulnerability to breast cancer among older women. The video, called "Aware and Alive," depicted women who had been diagnosed with breast cancer through mammography screening. In addition, a radio drama aimed at Ethiopian youth was designed to increase perceptions of risk and efficacy toward HIV/AIDS prevention. The 26-week long radio drama, called "Journey of Life," featured characters experiencing the negative consequences of their actions (to increase perceived threat) as well as the positive benefits of effective actions (to increase perceived efficacy).

It is good to carefully consider threats to your health and how threats to your health might affect your family, job, friendships, and ability to enjoy life. Health professionals who talk seriously with their patients about these issues are having an impact - informing their patients and motivating them to engage in healthier behaviors.

Cited Research

Copeland, A.L., & Brandon, T.H. (2000). Testing the causal role of expectancies in smoking motivation and behavior. Addictive Behaviors, Vol. 25, pp. 445-449.

Gibbons, F.X., Gerrard, M., Lane, D.J., Mahler, H.I.M., & Kulik, J.A.. Using UV photography to reduce use of tanning booths: A test of cognitive mediation. Health Psychology, Vol. 24 (4). pp. 358-363.

McCaul, K.D., & Mullens, A.B. (2003). Affect, thought, and self-protective health behavior: The case of worry and cancer screening. In J. Suls and K. Wallston (Eds.), Social Psychological Foundations of Health and Illness, Malden, MA: Blackwell Publishers.

Stephenson, M.T., & Witte, K. (1998). Fear, threat, and perceptions of efficacy from frightening skin cancer messages. Public Health Reviews, Vol. 26, pp. 147-174.

Weinstein, N.D., Lyon, J.E., Sandman, P.M., & Cuite, C.L. (1998). Experimental evidence for stages of health behavior change: the precaution adoption process model applied to home radon testing. Health Psychology, Vol. 17, pp. 445-453.

Witte, K., Meyer, G., & Martell, D. (2001). Effective health risk messages: A step-by- step guide. Newbury Park, CA: Sage.


American Psychological Association, July 7, 2004