Angst essen Impfbereitschaft auf?

Der Einfluss kognitiver und affektiver Faktoren auf die Risikowahrnehmung im Ausbruchsgeschehen
In der Diskussion

Zusammenfassung

In der Influenzapandemiezeit 2009 stand die Bevölkerung vor der Wahl, sich impfen zu lassen oder sich der Gefahr auszusetzen, an Influenza A (H1N1) zu erkranken. Das Wissen um eine wahrscheinliche Ansteckung und um möglicherweise schwerwiegende Krankheitsverläufe stand für viele Bürger im Gegensatz zu Gefühlen diffuser Angst vor dem Impfstoff. Was beeinflusst nun die (Impf-)Entscheidung stärker: die kognitive Einschätzung des Risikos oder das gefühlte Risiko? Anhand von Daten, die während dieser Pandemie erhoben wurden, testen wir in der hier vorgestellten Studie den relativen Einfluss von kognitiven und affektiven Aspekten der Risikowahrnehmung auf die Impfbereitschaft. Ferner legen wir ein besonderes Augenmerk auf Angst. Die Ergebnisse zeigen, dass das gefühlte Risiko die Impfbereitschaft signifikant beeinflusst, während die klassische kognitive Einschätzung des Risikos kein signifikanter Prädiktor mehr ist, sobald auch das gefühlte Risiko zur Vorhersage der Impfbereitschaft genutzt wird. Ein hohes gefühltes Risiko, an Influenza A (H1N1) zu erkranken, erhöhte die Impfbereitschaft deutlich; ein hohes gefühltes Impfrisiko senkte die Impfbereitschaft. Angst vor der Impfung verminderte die Impfintention signifikant, selbst wenn die Angst vor der ausbrechenden Krankheit sehr groß war. Die Ergebnisse werden hinsichtlich ihrer Implikationen für die Krisenkommunikation diskutiert.

Schlüsselwörter

Risk as feelings Angst Impfentscheidung Furchtappell 

Does fear affect the willingness to be vaccinated?

The influence of cognitive and affective aspects of risk perception during outbreaks

Abstract

During the influenza pandemic in 2009 individuals had the choice of either receiving a vaccination or running the risk of becoming infected with the pandemic influenza virus A (H1N1). For many individuals knowledge of a likely infection and possibly serious health consequences stood in contrast to a vague fear of the vaccination itself. What has a stronger influence on the decision to be vaccinated: the cognitive estimation of risk or the feeling of risk? Based on data collected during the 2009 influenza A (H1N1) pandemic we tested the relative influence of the cognitive and affective aspects of risk on estimation of the individual willingness to be vaccinated. In doing so we also focused on fear. The results indicate that the feeling of risk had a significant effect on the willingness to be vaccinated. In contrast, the classic, cognitive estimation of a risk was no longer a significant predictor when the feeling of risk was also used to predict the willingness to be vaccinated. A highly felt risk to become infected with influenza A (H1N1) substantially increased the willingness to be vaccinated. A highly felt risk regarding the vaccination, on the other hand, decreased the willingness to be vaccinated. Fear of the vaccination significantly decreased the willingness to be vaccinated even when fear of the spreading disease was also very high. The implications of the results for crisis communications will also be discussed.

Keywords

Risk as feelings Fear Vaccination decision Fear appeal 

Literatur

  1. 1.
    Gigerenzer G (2006) Out of the frying pan into the fire: behavioral reactions to terrorist attacks. Risk Anal 26:347–351PubMedCrossRefGoogle Scholar
  2. 2.
    Taylor-Robinson D, Elders K, Milton B, Thurston H (2009) Students‘ attitudes to the communications employed during an outbreak of meningococcal disease in a UK school: a qualitative study. J Public Health (Oxf) 32:32–37Google Scholar
  3. 3.
    Larson H, Cooper LZ, Eskola J et al (2011) Addressing the vaccine confidence gap. Lancet 378:526–535PubMedCrossRefGoogle Scholar
  4. 4.
    Krause G, Gilsdorf A, Becker J et al (2010) Erster Erfahrungsaustausch zur H1N1-Pandemie in Deutschland 2009/2010: Bericht über einen Workshop am 22. und 23. März 2010 in Berlin. [First exchange of experiences concerning the H1N1 pandemic in Germany 2009/2010: Report on a workshop held March 22–23, 2010, in Berlin]. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 53(5):510–519CrossRefGoogle Scholar
  5. 5.
    Van der Pligt J (1996) Risk perception and self- protective behavior. Eur Psychol 1:34–43CrossRefGoogle Scholar
  6. 6.
    Weinstein N (1993) Testing four competing theories of health-protective behavior. Health Psychol 12:324–333PubMedCrossRefGoogle Scholar
  7. 7.
    Brewer NT, Chapman GB, Gibbons FX et al (2007) Meta-analysis of the relationship between risk perception and health behavior: the example of vaccination. Health Psychol 26:136–145PubMedCrossRefGoogle Scholar
  8. 8.
    Betsch C, Wicker S (2012) E-health use, vaccination knowledge and perception of own risk: drivers of vaccination uptake in medical students. Vaccine 30:1143–1148PubMedCrossRefGoogle Scholar
  9. 9.
    Yates JF, Stone ER (1991) The risk construct. In: Yates JF (Hrsg) Risk-taking behavior. John Wiley & Sons, Oxford (England), S 1–25Google Scholar
  10. 10.
    Betsch C, Ulshöfer C, Renkewitz F, Betsch T (2011) The influence of narrative vs. statistic information on perceiving vaccination risks. Med Decis Making 31(5):742–753PubMedCrossRefGoogle Scholar
  11. 11.
    Betsch C, Renkewitz F, Haase N (2012) Effect of narrative reports about vaccine adverse events and bias-awareness disclaimers on vaccine decisions: a simulation of an online patient social network. Med Decis Making [Epub ahead of print]Google Scholar
  12. 12.
    Slovic P, Peters E (2006) Risk perception and affect. Curr Dir Psychol Sci 15(6):322–325CrossRefGoogle Scholar
  13. 13.
    Loewenstein G, Weber E, Hsee C, Welch N (2001) Risk as feelings. Psychol Bull 127(2):267–286PubMedCrossRefGoogle Scholar
  14. 14.
    Gelder J-L van, Vries RE de, Pligt J van der (2009) Evaluating a dual-process model of risk: affect and cognition as determinants of risky choice. J Behav Decis Mak 22(1):45–61CrossRefGoogle Scholar
  15. 15.
    Serino L, Meleleo C, Maurici M et al (2011) Knowledge and worry as basis for different behaviors among university students: the case of pandemic flu H1N1v. J Prev Med Hyg 52(3):144–147PubMedGoogle Scholar
  16. 16.
    Wong LP, Sam I-C (2011) Behavioral responses to the influenza A (H1N1) outbreak in Malaysia. J Behav Med 34:23–31PubMedCrossRefGoogle Scholar
  17. 17.
    Sotiriadis A, Dagklis T, Siamanta V et al (2012) Increasing fear of adverse effects drops intention to vaccinate after the introduction of prophylactic HPV vaccine. Arch Gynecol Obstet 285(6):1719–1724PubMedCrossRefGoogle Scholar
  18. 18.
    Bhat-Schelbert K, Jeng Lin C, Matambanadzo A et al (2012) Barriers to and facilitators of child influenza vaccine—perspectives from parents, teens, marketing and healthcare professionals. Vaccine 30(14):2448–2452PubMedCrossRefGoogle Scholar
  19. 19.
    Bond L, Nolan T (2011) Making sense of perceptions of risk of diseases and vaccinations: a qualitative study combining models of health beliefs, decision-making and risk perception. BMC Public Health 11:943PubMedCrossRefGoogle Scholar
  20. 20.
    Bundeszentrale für gesundheitliche Aufklärung (2011) Elternbefragung zum Thema „Impfen im Kindesalter“ – Ergebnisbericht. Köln 2011. http://www.bzga.de/forschung/studien-untersuchungen/studien/?sid=10&sub=64Google Scholar
  21. 21.
    Betsch C, Renkewitz F, Betsch T, Ulshöfer C (2010) The influence of vaccine-critical websites on perceiving vaccination risks. J Health Psychol 15(3):446–455PubMedCrossRefGoogle Scholar
  22. 22.
    Slovic P (1987) The perception of risk. Science 236:280–285PubMedCrossRefGoogle Scholar
  23. 23.
    Krause G (2010) Vortrag zu Influenza A (H1N1) 2009 – Ein epidemiologischer Rückblick. http://www.rki.de/cln_151/nn_197444/sid_FE4A67D2D22B99F63766C0D01E581767/DE/Content/InfAZ/I/Influenza/Pandemie/Vortrag.html?__nnn=trueGoogle Scholar
  24. 24.
    Weinstein ND, Kwitel A, McCaul KD et al (2007) Risk perceptions: assessment and relationship to influenza vaccination. Health Psychol 26:146–151PubMedCrossRefGoogle Scholar
  25. 25.
    Eagly AH, Chaiken S (1993) The psychology of attitudes. Harcourt, Brace, & Janovich, Fort Worth, TXGoogle Scholar
  26. 26.
    Word Health Organization (2012) Communication for behavioral impact. http://apps.who.int/iris/bitstream/10665/75170/1/WHO_HSE_GCR_2012.13_eng.pdfGoogle Scholar
  27. 27.
    Barry JM (2009) Pandemics: avoiding the mistake of 1918. Nature 459:324–325PubMedCrossRefGoogle Scholar
  28. 28.
    Brug J, Aro AR, Richardus JH (2009) Risk perceptions and behaviour: towards pandemic control of emerging infectious diseases. Int J Behav Med 16:3–6PubMedCrossRefGoogle Scholar
  29. 29.
    Sandman PM (2009) Pandemics: good hygiene is not enough. Nature 459:322–323PubMedCrossRefGoogle Scholar
  30. 30.
    Maher B (2010) Crisis communicator. Nature 463:150–152PubMedCrossRefGoogle Scholar
  31. 31.
    Green EC, Witte K (2006) Can fear arousal in public health campaigns contribute to the decline of HIV prevalence? J Health Commun 11:245–259PubMedCrossRefGoogle Scholar
  32. 32.
    Witte K, Allen M (2000) A meta-analysis of fear appeals: implications for effective public health campaigns. Health Educ Behav 27:591–615PubMedCrossRefGoogle Scholar
  33. 33.
    Cook J, Lewandowsky S (2011) The debunking handbook. http://www.skepticalscience.com/Debunking-Handbook-now-freely-available-download.htmlGoogle Scholar
  34. 34.
    Betsch C, Sachse K (im Druck) Debunking vaccination myths—strong risk negations can increase perceived vaccination risks. Health Psychol, doi:10.1037/a0027387Google Scholar
  35. 35.
    Johnson HM, Seifert CM (1994) Sources of the continued influence effect: when discredited information in memory affects later inferences. J Exp Psychol Learn Mem Cogn 20(6):1420–1436CrossRefGoogle Scholar
  36. 36.
    Skurnik I, Yoon C, Park D, Schwarz N (2005) How warnings about false claims become recommendations. J Consum Res 31:713–724CrossRefGoogle Scholar
  37. 37.
    WHO (2009) Global pandemic influenza action plan to increase vaccine supply: progress report 2006–2008. http://whqlibdoc.who.int/hq/2009/WHO_IVB_09.05_eng.pdfGoogle Scholar
  38. 38.
    Gidengil CA, Parker AM, Zikmund-Fisher BJ (2012) Trends in risk perceptions and vaccination intentions: a longitudinal study of the first year of the H1N1 pandemic. Am J Public Health 102(4):672–679PubMedCrossRefGoogle Scholar
  39. 39.
    Gatewood AH, Buckeridge DL, Charland KML et al (2011) Effect of expanded US recommendations for seasonal influenza vaccination: comparison of two pediatric emergency departments in the United States and Canada. CMAJ 183(13), doi:10.1503/cmaj.110241Google Scholar
  40. 40.
    Beasley D (2011) Survey shows more US children getting vaccines. http://www.reuters.com/article/2011/09/01/usa-vaccines-idUSN1E7801L020110901Google Scholar
  41. 41.
    Larson H (2011) Project to monitor public confidence in immunization programs. http://www.lshtm.ac.uk/eph/ide/research/vaccinetrust/Google Scholar
  42. 42.
    Eysenbach G (2009) Infodemiology and infoveillance: framework for an emerging set of public health informatics methods to analyze search, communication and publication behavior on the Internet. J Med Internet Res 11(1):e11, doi:10.2196/jmir.1157PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Center for Empirical Research in Economics and Behavioral Sciences (CEREB)Universität ErfurtErfurtDeutschland

Personalised recommendations