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The Concept of Risk Perception in Health-Related Behavior Theory and Behavior Change

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Perceived Safety

Part of the book series: Risk Engineering ((RISK))

Abstract

Messages aiming to increase the public’s perception of health and safety risks, such as the spread of antibiotic-resistant pathogens, are omnipresent. In these cases, the basic assumption often is that a heightened level of risk perception should lead to more protective behaviours like proper hand hygiene in hospitals. The notion that people’s perception of health risks influences their risk-taking or safety behaviour is prevalent both in health behaviour theories and applied health communication. However, research findings on the connection between risk perception and health-related behaviour are not clear-cut. In the present chapter, we look at the different operationalisations of the term risk perception and discuss several methodological issues that are widespread in the health risk perception literature which might have led to inconclusive results. Overall, even though the effect sizes are generally moderate, the majority of research findings indicate that risk perception influences health- and safety-related behaviour. This was shown both in research looking at a variety of different health-related behaviours at the same time as well as in studies only concerned with specific activities such as hand hygiene and vaccination. Therefore, risk perception as a concept truly deserves its place in health behaviour theory and behaviour change interventions. Some implications of these findings on intervention design are discussed.

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Notes

  1. 1.

    The authors used the term risk appraisal for their categorisation system, because they reserved the term risk perception only for the cognitive evaluation of a potential threat (i.e., likelihood). There seem to be a lack of taxonomical consensus in the research area investigating the relationship between risk perception and health-related behaviour. For easier comprehensibility, the term risk perception was adopted for the generalised concept throughout the present chapter.

  2. 2.

    An effect size is an objective and standardised measures of the magnitude of the observed statistical effect. The main benefits of having a standardised measure are, that effect sizes of different studies can be compared at the same level and that it allows an inference about the meaningfulness/importance of the effect. There are several standard measures of effect sizes. The most commonly used are Cohen’s d which indicates mean differences between two groups and the Pearson correlation coefficient r, which is an expression of the strength of the relationship between variables. Cohen (1988) proposed indications on how to interpret the effect sizes. For the Cohen’s d: d = 0.2 (small effect), d = 0.5 (medium effect), and d = 0.8 (large effect). For the Pearson correlation coefficient r: r = .1 (small effect), r = .3 (medium effect), and r = .5 (large effect).

References

  • Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211.

    Google Scholar 

  • Bish, A., Yardley, L., Nicoll, A., & Michie, S. (2011). Factors associated with uptake of vaccination against pandemic influenza: A systematic review. Vaccine, 29(38), 6472–6484.

    Google Scholar 

  • Brewer, N. T., Chapman, G. B., Gibbons, F. X., Gerrard, M., McCaul, K. D., & Weinstein, N. D. (2007). Meta-analysis of the relationship between risk perception and health behavior: The example of vaccination. Health Psychology, 26(2), 136–145.

    Google Scholar 

  • Brewer, N. T., Weinstein, N. D., Cuite, C. L., & Herrington, J. E. (2004). Risk perceptions and their relation to risk behavior. Annals of Behavioral Medicine, 27(2), 125–130.

    Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). New York: Academic Press.

    MATH  Google Scholar 

  • Cox, D., Sturm, L., & Cox, A. D. (2014). Effectiveness of asking anticipated regret in increasing HPV vaccination intention in mothers. Health Psychology, 33(9), 1074–1083.

    Google Scholar 

  • Diefenbacher, S., Sassenrath, C., Siegel, A., Grünewald, M., & Keller, J. (2012). Implizite Einstellung zur Händehygiene als relevanter Prädiktor von Händehygieneverhalten. Hygiene & Medizin, 38(11), 448–455.

    Google Scholar 

  • Dubé, E., Laberge, C., Guay, M., Bramadat, P., Roy, R., & Bettinger, J. A. (2013). Vaccine hesitancy: An overview. Human Vaccines & Immunotherapeutics, 9(8), 1763–1773.

    Google Scholar 

  • Erasmus, V., Daha, T. J., Brug, H., Richardus, J. H., Behrendt, M. D., Vos, M. C., et al. (2010). Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infection Control and Hospital Epidemiology, 31(3), 283–294.

    Google Scholar 

  • Field, A., Miles, J., & Field, Z. (2012). Discovering Statistics Using R. London: SAGE Publications Ltd.

    Google Scholar 

  • Floyd, D. L., Prentice-Dunn, S., & Rogers, R. W. (2000). A meta-analysis of research on protection motivation theory. Journal of Applied Social Psychology, 30(2), 407–429.

    Google Scholar 

  • Fuller, C., Besser, S., Savage, J., McAteer, J., Stone, S., & Michie, S. (2014). Application of a theoretical framework for behavior change to hospital workers’ real-time explanations for noncompliance with hand hygiene guidelines. American Journal of Infection Control, 42(2), 106–110.

    Google Scholar 

  • Gaube, S., Lermer, E., & Fischer, P. (2018a). Identifying psychological factors that influence hospital visitor’s hand hygiene behavior. Manuscript in preparation.

    Google Scholar 

  • Gaube, S., Tsivrikos, D., Dollinger, D., & Lermer, E. (2018b). How a smiley protects health: A pilot intervention to improve hand hygiene in hospitals by activating injunctive norms through emoticons. PLoS ONE, 13(5), e0197465.

    Google Scholar 

  • Hastings, G., Stead, M., & Webb, J. (2004). Fear appeals in social marketing: Strategic and ethical reasons for concern. Psychology & Marketing, 21(11), 961–986.

    Google Scholar 

  • Joffe, H. (2008). The power of visual material: Persuasion, emotion and identification. Diogenes, 55(1), 84–93.

    Google Scholar 

  • Leshner, G., Bolls, P., & Thomas, E. (2009). Scare’em or disgust’em: The effects of graphic health promotion messages. Health Communication, 24(5), 447–458.

    Google Scholar 

  • Lermer, E., Raue, M., & Frey, D. (2016). Risikowahrnehmung und Risikoverhalten. In D. Frey & H.-W. Bierhoff (Eds.), Enzyklopädie der Psychologie—Soziale Motive und soziale Einstellungen—Sozialpsychologie. Göttingen: Hogrefe.

    Google Scholar 

  • Lermer, E., Streicher, B., & Raue, M. (2018). Measuring subjective risk estimates. In M. Raue, E. Lermer, & B. Streicher (Eds.), Psychological Perspectives on Risk and Risk Analysis: Theory, Models and Applications. New York: Springer.

    Google Scholar 

  • Lermer, E., Streicher, B., Sachs, R., & Frey, D. (2013). How risky? The impact of target person and answer format on risk assessment. Journal of Risk Research, 16(7), 903–919.

    Google Scholar 

  • Leventhal, H., Kelly, K., & Leventhal, E. A. (1999). Population risk, actual risk, perceived risk, and cancer control: A discussion. Journal of the National Cancer Institute Monographs, 25, 81–85.

    Google Scholar 

  • Loewenstein, G. F., Weber, E. U., Hsee, C. K., & Welch, N. (2001). Risk as feelings. Psychological Bulletin, 127(2), 267–286.

    Google Scholar 

  • McCaul, K. D., & Mullens, A. B. (2003). Affect, thought and self-protective health behavior: the case of worry and cancer screening. In J. Suls & K. A. Wallston (Eds.), Social psychological foundations of health and illness. Malden (MA): Blackwell Publishing Ltd.

    Google Scholar 

  • McEachan, R. R., Conner, M., Taylor, N. J., & Lawton, R. J. (2011). Prospective prediction of health-related behaviours with the theory of planned behavior: A meta-analysis. Health Psychology Review, 5(2), 97–144.

    Google Scholar 

  • Milne, S., Sheeran, P., & Orbell, S. (2000). Prediction and intervention in health-related behavior: A meta-analytic review of protection motivation theory. Journal of Applied Social Psychology, 30(1), 106–143.

    Google Scholar 

  • Newman, P. A., Logie, C. H., Doukas, N., & Asakura, K. (2013). HPV vaccine acceptability among men: A systematic review and meta-analysis. Sex Transm Infect, 89(7), 568–574.

    Google Scholar 

  • Otten, W., & Van der Pligt, J. (1992). Risk and behavior: The mediating role of risk appraisal. Acta Psychologica, 80(1–3), 325–346.

    Google Scholar 

  • Ouellette, J. A., & Wood, W. (1998). Habit and intention in everyday life: The multiple processes by which past behavior predicts future behavior. Psychological Bulletin, 124(1), 54–74.

    Google Scholar 

  • Pessoa-Silva, C. L., Posfay-Barbe, K., Pfister, R., Touveneau, S., Perneger, T. V., & Pittet, D. (2005). Attitudes and perceptions toward hand hygiene among healthcare workers caring for critically ill neonates. Infection Control and Hospital Epidemiology, 26(3), 305–311.

    Google Scholar 

  • Peters, E., McCaul, K. D., Stefanek, M., & Nelson, W. (2006). A heuristics approach to understanding cancer risk perception: Contributions from judgment and decision-making research. Annals of Behavioral Medicine, 31(1), 45–52.

    Google Scholar 

  • Pittet, D., Simon, A., Hugonnet, S., Pessoa-Silva, C. L., Sauvan, V., & Perneger, T. V. (2004). Hand hygiene among physicians: Performance, beliefs, and perceptions. Annals of Internal Medicine, 141(1), 1–8.

    Google Scholar 

  • Reynolds, T. (2001). News headlines feed on fear of cancer risk, experts say. Journal of the National Cancer Institute, 93(1), 9–11.

    Google Scholar 

  • Rogers, R. W. (1983). Cognitive and psychological processes in fear appeals and attitude change: A revised theory of protection motivation. In J. Cacioppo & R. Petty (Eds.), Social psychophysiology. New York: Guilford Press.

    Google Scholar 

  • Rosenstock, I. (1966). Why people use health services. The Milbank Memorial Fund Quarterly, 44, 94–127.

    Google Scholar 

  • Ruiter, R. A., Kessels, L. T., Peters, G. J. Y., & Kok, G. (2014). Sixty years of fear appeal research: Current state of the evidence. International Journal of Psychology, 49(2), 63–70.

    Google Scholar 

  • Sax, H., Uckay, I., Richet, H., Allegranzi, B., & Pittet, D. (2007). Determinants of good adherence to hand hygiene among healthcare workers who have extensive exposure to hand hygiene campaigns. Infection Control and Hospital Epidemiology, 28(11), 1267–1274.

    Google Scholar 

  • Schwarzer, R. (2008). Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors. Applied Psychology, 57(1), 1–29.

    Google Scholar 

  • Schwarzer, R., Lippke, S., & Luszczynska, A. (2011). Mechanisms of health behavior change in persons with chronic illness or disability: The health action process approach (HAPA). Rehabilitation Psychology, 56(3), 161–170.

    Google Scholar 

  • Sheeran, P., Harris, P. R., & Epton, T. (2014). Does heightening risk appraisals change people’s intentions and behavior? A meta-analysis of experimental studies. Psychological Bulletin, 140(2), 511–543.

    Google Scholar 

  • Sheeran, P., Klein, W. M., & Rothman, A. J. (2017). Health behavior change: Moving from observation to intervention. Annual Review of Psychology, 68, 573–600.

    Google Scholar 

  • Slovic, P. (2010). The feeling of risk: New perspectives on risk perception. Oxford, UK: Routledge.

    Google Scholar 

  • Slovic, P., Finucane, M., Peters, E., & MacGregor, D. G. (2002). Rational actors or rational fools: Implications of the affect heuristic for behavioral economics. The Journal of Socio-Economics, 31(4), 329–342.

    Google Scholar 

  • Slovic, P., & Peters, E. (2006). Risk perception and affect. Current Directions in Psychological Science, 15(6), 322–325.

    Google Scholar 

  • Sniehotta, F. F., Scholz, U., & Schwarzer, R. (2005). Bridging the intention–behavior gap: Planning, self-efficacy, and action control in the adoption and maintenance of physical exercise. Psychology & Health, 20(2), 143–160.

    Google Scholar 

  • van der Pligt, J. (1996). Risk perception and self-protective behavior. European Psychologist, 1(1), 34–43.

    Google Scholar 

  • von Leszczynski, U. (2016). Killerkeime: Der Tod aus dem Krankenhaus. Südwest Presse. Retrieved from https://www.swp.de/panorama/der-tod-aus-dem-krankenhaus-23162265.html.

  • Weinstein, N. D., Kwitel, A., McCaul, K. D., Magnan, R. E., Gerrard, M., & Gibbons, F. X. (2007). Risk perceptions: Assessment and relationship to influenza vaccination. Health Psychology, 26(2), 146–151.

    Google Scholar 

  • Weinstein, N. D., & Nicolich, M. (1993). Correct and incorrect interpretations of correlations between risk perceptions and risk behaviors. Health Psychology, 12(3), 235–245.

    Google Scholar 

  • WHO (2009). WHO Guidelines on Hand Hygiene in Health Care: A Summary. First Global Patient Safety Challenge Clean Care is Safer Care. Retrieved from http://www.who.int/gpsc/5may/tools/9789241597906/en/.

  • WHO (2013). Global Vaccine Action Plan 2011–2020. Retrieved from http://www.who.int/immunization/global_vaccine_action_plan/GVAP_doc_2011_2020/en/.

  • Witte, K. (1992). Putting the fear back into fear appeals: The extended parallel process model. Communications Monographs, 59(4), 329–349.

    Google Scholar 

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Authors and Affiliations

  1. Department of Experimental Psychology, University of Regensburg, Universitätsstr. 31, 93053, Regensburg, Germany

    Susanne Gaube, Eva Lermer & Peter Fischer

  2. FOM University of Applied Sciences for Economics & Management, Arnulfstr. 30, 80335, Munich, Germany

    Eva Lermer

Authors
  1. Susanne Gaube
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  2. Eva Lermer
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  3. Peter Fischer
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Correspondence to Susanne Gaube .

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Editors and Affiliations

  1. AgeLab, Massachusetts Institute of Technology, Cambridge, MA, USA

    Martina Raue

  2. Institute of Psychology—RiskLab, UMIT—Private University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Tyrol, Austria

    Bernhard Streicher

  3. Department of Experimental Psychology, University of Regensburg, Regensburg, Bavaria, Germany

    Eva Lermer

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Gaube, S., Lermer, E., Fischer, P. (2019). The Concept of Risk Perception in Health-Related Behavior Theory and Behavior Change. In: Raue, M., Streicher, B., Lermer, E. (eds) Perceived Safety. Risk Engineering. Springer, Cham. https://doi.org/10.1007/978-3-030-11456-5_7

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  • DOI: https://doi.org/10.1007/978-3-030-11456-5_7

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