Perceived ambiguity about cancer prevention recommendations: relationship to perceptions of cancer preventability, risk, and worry.
ABSTRACT In this study, we apply the concept of "ambiguity," as developed in the decision theory literature, to an analysis of potential psychological consequences of uncertainty about cancer prevention recommendations. We used Health Information National Trends Survey (HINTS) 2003 data to examine how perceived ambiguity about cancer prevention recommendations relates to three other cognitive variables known to influence cancer-protective behavior: perceived cancer preventability, perceived cancer risk, and cancer-related worry. Using logistic regression analyses, we tested several predictions derived from a review of literature on the effects of ambiguity perceptions on decision making, cognitions, and emotions. We found perceived ambiguity to have a strong negative relationship with perceived cancer preventability, consistent with "ambiguity aversion"-a pessimistic bias in the interpretation of ambiguity. Cancer worry moderated this relationship; ambiguity aversion increased with higher levels of worry. At the same time, perceived ambiguity was positively related to both perceived cancer risk and cancer worry. Furthermore, perceived risk partially mediated the relationship between perceived ambiguity and worry. These findings suggest that perceived ambiguity about cancer prevention recommendations may have broad and important effects on other health cognitions. We discuss ethical implications of these findings for health communication efforts, and propose a tentative causal model to guide future research.
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ABSTRACT: Barriers to communicating the uncertainty of environmental health risks include preferences for certain information and low numeracy. Map features designed to communicate the magnitude and uncertainty of estimated cancer risk from air pollution were tested among 826 participants to assess how map features influenced judgments of adequacy and the intended communication goals. An uncertain versus certain visual feature was judged as less adequate but met both communication goals and addressed numeracy barriers. Expressing relative risk using words communicated uncertainty and addressed numeracy barriers but was judged as highly inadequate. Risk communication and visual cognition concepts were applied to explain findings.Science Communication 02/2015; 37(1):59-88. DOI:10.1177/1075547014565908 · 2.08 Impact Factor
Article: Decision making and cancer.[Show abstract] [Hide abstract]
ABSTRACT: We review decision making along the cancer continuum in the contemporary context of informed and shared decision making in which patients are encouraged to take a more active role in their health care. We discuss challenges to achieving informed and shared decision making, including cognitive limitations and emotional factors, but argue that understanding the mechanisms of decision making offers hope for improving decision support. Theoretical approaches to decision making that explain cognition, emotion, and their interaction are described, including classical psychophysical approaches, dual-process approaches that focus on conflicts between emotion versus cognition (or reason), and modern integrative approaches such as fuzzy-trace theory. In contrast to the earlier emphasis on rote use of numerical detail, modern approaches emphasize understanding the bottom-line gist of options (which encompasses emotion and other influences on meaning) and retrieving relevant social and moral values to apply to those gist representations. Finally, research on interventions to support better decision making in clinical settings is reviewed, drawing out implications for future research on decision making and cancer. (PsycINFO Database Record (c) 2015 APA, all rights reserved).American Psychologist 02/2015; 70(2):105-118. DOI:10.1037/a0036834 · 6.87 Impact Factor
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ABSTRACT: The perception that extant health messages about risk factors for a disease are ambiguous can be associated with greater anxiety and reduced interest in taking precautionary action. In this experiment, 247 female alcohol consumers who perceived varying degrees of ambiguity in current cancer prevention messages read an unambiguous article about the documented link between alcohol consumption and breast cancer. Before reading the article, half were given the opportunity to self-affirm by reflecting on an important value-a technique previously shown to enhance receptivity to threatening messages. The authors found that self-affirmation increased message acceptance among those who perceived relatively higher levels of ambiguity in cancer communications. Also, the relation between perceived ambiguity and risk perception became positive among self-affirmed participants, suggesting they had become less defensive. Self-affirmation may be an effective technique to use when delivering health communications to audiences who perceive a lack of consistency in prevention messages.Journal of Health Communication 03/2015; DOI:10.1080/10810730.2014.999892 · 1.61 Impact Factor