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Breast Cancer and Environment Breast Cancer and Environment Pre-ConferencePre-Conference

November 8, 2005November 8, 2005Michigan State University, Lansing, MIMichigan State University, Lansing, MI

Katherine McComasKatherine McComas, PhD, PhD

Department of Communication Department of Communication Cornell University, Ithaca, NYCornell University, Ithaca, NY

Strategic Risk Strategic Risk Communication Involving Communication Involving

Environmental Environmental Health IssuesHealth Issues

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What is Risk?What is Risk?

““things, forces, or circumstances that pose things, forces, or circumstances that pose danger to people or to what they value” danger to people or to what they value” (Stern & Fineberg, 1996, p. 215)(Stern & Fineberg, 1996, p. 215)

It encompasses subjective and objective It encompasses subjective and objective qualitiesqualities

Risk judgments, to some degree, are by-Risk judgments, to some degree, are by-products of social, cultural, and products of social, cultural, and psychological influences (Slovic, 1999)psychological influences (Slovic, 1999)

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What is Risk Communication?What is Risk Communication?

……An iterative process among scientists and An iterative process among scientists and non-scientists about the assessment, non-scientists about the assessment, characterization, and management of risk.characterization, and management of risk. Includes purposeful and unintentional messages Includes purposeful and unintentional messages

about risk,about risk, Is multi-directional,Is multi-directional, Encompasses verbal and nonverbal cues, andEncompasses verbal and nonverbal cues, and Occurs at personal, group, organizational, community, Occurs at personal, group, organizational, community,

and societal levels.and societal levels.

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““[Risk communication] enters our lives in a multitude of [Risk communication] enters our lives in a multitude of forms, sometimes part of the imagery of advertising, forms, sometimes part of the imagery of advertising, sometimes a local corporation’s formal statement, or its sometimes a local corporation’s formal statement, or its failure to say anything, sometimes a multi-volumed and failure to say anything, sometimes a multi-volumed and impenetrable technical risk assessment”impenetrable technical risk assessment”

(Kasperson & Palmlund, 1987, as cited in Plough & Krimsky, 1987) (Kasperson & Palmlund, 1987, as cited in Plough & Krimsky, 1987)

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The Challenge of Risk The Challenge of Risk CommunicationCommunication

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

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The “Rub”The “Rub”

““No matter how accurate it is, risk No matter how accurate it is, risk information may be misperceived or information may be misperceived or rejected if those who give information rejected if those who give information are unaware of the complex, are unaware of the complex, interactive nature of risk interactive nature of risk communication and the various factors communication and the various factors affecting the reception of the risk affecting the reception of the risk message.” message.”

(Fessenden-Raden et al., 1987, p. 100)(Fessenden-Raden et al., 1987, p. 100)

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The manner by which information is The manner by which information is provided, provided,

the structure of arguments, the structure of arguments, the persuasive nature of the message, the persuasive nature of the message, the sources used, andthe sources used, and the nature of the risk…the nature of the risk…

……all influence audience response to all influence audience response to environmental health risk messages.environmental health risk messages.

PremisePremise

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Questions to ConsiderQuestions to Consider

How complex is the information?How complex is the information? What if the science is uncertain?What if the science is uncertain? Are unintentional risk messages also Are unintentional risk messages also

being sent?being sent? Are there multiple messengers?Are there multiple messengers? Do some messages conflict with Do some messages conflict with

others?others? What are the media saying?What are the media saying?

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Mass MediaMass Media

If most people get most If most people get most of their information of their information from the mass media, from the mass media, what are the media what are the media saying?saying?

One study found that One study found that articles in women’s articles in women’s magazines discussing magazines discussing breast cancer risks breast cancer risks tended to report tended to report incorrect or incomplete incorrect or incomplete information (Marino & information (Marino & Gerlach, 1999)Gerlach, 1999)

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1111

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To communicate risk and design effective To communicate risk and design effective messages, it is imperative to understand messages, it is imperative to understand how… how… lay audiences process understand alternative lay audiences process understand alternative

ways of characterizing environmental health ways of characterizing environmental health risk assessments, andrisk assessments, and

the role of message structure in influencing the role of message structure in influencing perceptions and behaviors. perceptions and behaviors.

Effective Message DesignEffective Message Design

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Audience CharacteristicsAudience Characteristics

Past experiences with the topic and Past experiences with the topic and information sourcesinformation sources

Prior knowledge of the topicPrior knowledge of the topic Health of the individual and family membersHealth of the individual and family members Where relevant, attitudes toward the Where relevant, attitudes toward the

organization viewed responsible for the riskorganization viewed responsible for the risk CultureCulture Risk perceptionsRisk perceptions

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

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What Do You Fear Most?What Do You Fear Most?

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

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Annual Deaths/RiskAnnual Deaths/Risk

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

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Some Factors Influencing Some Factors Influencing Risk PerceptionsRisk Perceptions

Can I see it?Can I see it? Will I know if I’m Will I know if I’m

exposed?exposed? Are the effects Are the effects

immediate?immediate? Do scientists know and Do scientists know and

understand the risks?understand the risks? Can I control my Can I control my

exposure? exposure? Can I easily reduce my Can I easily reduce my

exposureexposure

Is my exposure Is my exposure voluntary?voluntary?

Is it a “dreaded” risk?Is it a “dreaded” risk? Are the risks borne Are the risks borne

equally or fairly?equally or fairly? Does it pose a risk to Does it pose a risk to

future generations?future generations? Are the risks Are the risks

decreasing or decreasing or increasing?increasing?

(Slovic, 2000)

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Why Does It Matter?Why Does It Matter?

Understanding how people evaluate risk may Understanding how people evaluate risk may help risk communicators predict how help risk communicators predict how concerned people may be about a risk.concerned people may be about a risk.

Under some circumstances, risk Under some circumstances, risk communicators may be able to lessen communicators may be able to lessen unnecessary concern by emphasizing certain unnecessary concern by emphasizing certain actions that people can take, for example, to actions that people can take, for example, to reduce or control their exposure to a risk.reduce or control their exposure to a risk.

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Affect and Risk JudgmentsAffect and Risk Judgments

People judge risk based not only on what they People judge risk based not only on what they think about it, but also on what they feel about it.think about it, but also on what they feel about it.

When people associate positive feelings with the When people associate positive feelings with the activity, they view it as less risky, and vice versa.activity, they view it as less risky, and vice versa.

When people worry more, they are more likely to When people worry more, they are more likely to seek information.seek information.

(Slovic, 1999; Griffin et al., 1999)(Slovic, 1999; Griffin et al., 1999)

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Why Does It Matter?Why Does It Matter?

Emotions can override other considerations.Emotions can override other considerations. May help to explain gender and age-related May help to explain gender and age-related

differences in risk perceptions.differences in risk perceptions. May help to explain why vivid language, May help to explain why vivid language,

narratives, or affective-laden imagery strongly narratives, or affective-laden imagery strongly influence people’s reactions to risk.influence people’s reactions to risk.

(Loewenstein, 2001)(Loewenstein, 2001)

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Optimistic BiasOptimistic Bias

When asked to rate their chances of being When asked to rate their chances of being harmed harmed or or experiencing a positive event, people experiencing a positive event, people tend to rate their chances as above or below tend to rate their chances as above or below average.average.

So, why is this called “unrealistic optimism”?So, why is this called “unrealistic optimism”? If these beliefs were not biased, in a representative If these beliefs were not biased, in a representative

sample, claims of being sample, claims of being belowbelow average risk, for average risk, for instance, would be balanced by claims of being instance, would be balanced by claims of being aboveabove average risk. average risk.

(Weinstein, 1989)(Weinstein, 1989)

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Why Causes Optimistic Bias?Why Causes Optimistic Bias?

People compare themselves to an incorrect norm. People compare themselves to an incorrect norm. People tend to have stereotypes in mind when they think about People tend to have stereotypes in mind when they think about

who is usually at risk from something. If they do not fit this who is usually at risk from something. If they do not fit this stereotype, then they will downplay the likelihood of the event stereotype, then they will downplay the likelihood of the event happening to them.happening to them.

People interpret risk information in a self-serving People interpret risk information in a self-serving manner.manner.

People employ “ego-defensive” mechanisms to People employ “ego-defensive” mechanisms to downplay their risks.downplay their risks.

People believe they have more control over a situation People believe they have more control over a situation than they really do.than they really do.

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Limiting Optimistic BiasLimiting Optimistic Bias

When comparing our chances of being exposed to a risk When comparing our chances of being exposed to a risk to someone else’s, the more like us that someone else to someone else’s, the more like us that someone else is, the less we have unrealistic optimism.is, the less we have unrealistic optimism.

When we perceive less control over our exposure to risk, When we perceive less control over our exposure to risk, or view this exposure as less voluntary, unrealistic or view this exposure as less voluntary, unrealistic optimism decreases. optimism decreases.

Amount of information people are exposed to about a Amount of information people are exposed to about a risk, and how salient or risk, and how salient or meaningfulmeaningful that information is to that information is to them personally can influence optimistic biases.them personally can influence optimistic biases.

Personal exposure to a risk can reduce unrealistic Personal exposure to a risk can reduce unrealistic optimism.optimism.

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Why Does It Matter?Why Does It Matter?

Unrealistic optimism may hinder efforts to Unrealistic optimism may hinder efforts to promote risk decreasing behavior.promote risk decreasing behavior. People do not think they are at risk or that the People do not think they are at risk or that the

risks pose much danger to their health and risks pose much danger to their health and safety.safety.

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Trust and Source CredibilityTrust and Source Credibility

To what extent do individuals perceive the To what extent do individuals perceive the source as trustworthy and/or credible? source as trustworthy and/or credible? Can depend on perceived shared values Can depend on perceived shared values

(Siegrist et al., 2001)(Siegrist et al., 2001) Also influenced by source’s perceivedAlso influenced by source’s perceived

OpennessOpenness Caring/ConcernCaring/Concern BiasBias FairnessFairness ExpertiseExpertise

(Meyer, 1988)(Meyer, 1988)

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Why Does It Matter?Why Does It Matter?

When individuals distrust the source, When individuals distrust the source, they distrust the information.they distrust the information.

They also often perceive the risks as They also often perceive the risks as more severe.more severe.

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WhenWhen Should Risk Should Risk Communication Occur?Communication Occur?

““Should we wait until we’re certain?”Should we wait until we’re certain?” Proactive vs. reactive risk communicationProactive vs. reactive risk communication

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Proactive Risk Proactive Risk CommunicationCommunication

Calls attention to a risk issue, both potential and Calls attention to a risk issue, both potential and existing, suggests the agenda for discussion, and existing, suggests the agenda for discussion, and provides mechanisms for information exchangeprovides mechanisms for information exchange Disadvantages: Disadvantages:

May alert people to something of which they are not awareMay alert people to something of which they are not aware Advantages: Advantages:

May alert people to something of which they are not awareMay alert people to something of which they are not aware May allow for a much more meaningful discussion of riskMay allow for a much more meaningful discussion of risk May generate more balanced discussionMay generate more balanced discussion

(Scherer, 1991)(Scherer, 1991) Can increase trustCan increase trust

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Reactive Risk CommunicationReactive Risk Communication

Does not call attention to a particular risk but waits Does not call attention to a particular risk but waits until there is already considerable public and until there is already considerable public and media attention about a risk issuemedia attention about a risk issue AdvantageAdvantage

Allows the public to vent about the issueAllows the public to vent about the issue Disadvantages: Disadvantages:

Science may be less relevant when issues become highly Science may be less relevant when issues become highly emotionally chargedemotionally charged

Places communicator in defensive positionPlaces communicator in defensive position People may not believe information that is delayedPeople may not believe information that is delayed People may not have information they need to protect their or People may not have information they need to protect their or

their family’s health and safetytheir family’s health and safety

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Developing Risk MessagesDeveloping Risk Messages

Now that you’ve decided to communicate, Now that you’ve decided to communicate, what should your message include?what should your message include?

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Message StrategiesMessage Strategies

1.1. PersuasivePersuasive2.2. BalancedBalanced3.3. NarrativeNarrative4.4. DialecticalDialectical

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(1) Persuasive Approaches(1) Persuasive Approaches

Typically one-sided approach seeking to Typically one-sided approach seeking to convince audience to change attitudes and convince audience to change attitudes and behaviors in a particular direction.behaviors in a particular direction. Sometimes referred to as advocacy approaches.Sometimes referred to as advocacy approaches.

Key factors influencing persuasion include Key factors influencing persuasion include source characteristics (e.g., credibility), source characteristics (e.g., credibility), message design, and audience message design, and audience characteristics. characteristics.

Work best where there is scientific consensus Work best where there is scientific consensus and “social” agreement about risks.and “social” agreement about risks.

(Fischhoff, 1999)(Fischhoff, 1999)

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(2) Balanced Models(2) Balanced Models

Typical of mass media coverage. Typical of mass media coverage. Often presents multiple perspectives or Often presents multiple perspectives or

opinions but stops short of advocating a opinions but stops short of advocating a particular positionparticular position thus frequently leaving audiences without thus frequently leaving audiences without

specific behavioral guidancespecific behavioral guidance. . Presents all sides as equally as possible Presents all sides as equally as possible

and then lets individuals make up their and then lets individuals make up their mind.mind.

Sometimes referred to as journalistic Sometimes referred to as journalistic approach (minus the editorializingapproach (minus the editorializing).).

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(3) Narrative Approaches(3) Narrative Approaches

Stories can personalize the risk, making it Stories can personalize the risk, making it seem more “real”seem more “real”

Media usually highlight someone’s storyMedia usually highlight someone’s story Narrative factors guide audience reaction Narrative factors guide audience reaction

to the messagesto the messages Stories help disseminate shared values, Stories help disseminate shared values,

which may promote trust which may promote trust (Greene & Brinn, 2003; Siegrist et al., 2001)(Greene & Brinn, 2003; Siegrist et al., 2001)

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(4) Dialectical Models(4) Dialectical Models

Uses a series of questions and answers to Uses a series of questions and answers to probe through possibilities and weigh probe through possibilities and weigh contradictory facts and opinions with a view contradictory facts and opinions with a view to their resolution. to their resolution.

Does not advocate a particular position but Does not advocate a particular position but tries to equip audiences with tools tries to equip audiences with tools necessary to evaluate information.necessary to evaluate information.

Interactive techniques used to involve the Interactive techniques used to involve the public in environmental decision making public in environmental decision making employ similar strategies.employ similar strategies.

(Scherer et al., 1999)(Scherer et al., 1999)

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Questions to ConsiderQuestions to Consider

When choosing a message strategies, When choosing a message strategies, risk communication efforts should ask: risk communication efforts should ask: Who is the target audience?Who is the target audience? What is the objective of the message?What is the objective of the message?

Provide informationProvide information Promote more critical thinking or informed Promote more critical thinking or informed

judgments about riskjudgments about risk Promote attitude or behavior changePromote attitude or behavior change Build trust among communicators and audienceBuild trust among communicators and audience

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Additional Message ElementsAdditional Message Elements Risk severityRisk severity

More severe risks gain more attention, More severe risks gain more attention, but can go too farbut can go too far

Efficacy statementsEfficacy statements When people believe they have the When people believe they have the

ability to change, and that the change ability to change, and that the change will indeed help, they are more likely to will indeed help, they are more likely to adopt protective behavior (Witte, 1994).adopt protective behavior (Witte, 1994).

ComparisonsComparisons Work best when source is trusted and Work best when source is trusted and

comparisons are within the same “family” comparisons are within the same “family” of risks (Johnson & Chess, 2003)of risks (Johnson & Chess, 2003)

VisualsVisuals A strong communication tool when used A strong communication tool when used

thoughtfully (Lipkus & Hollands, 1999)thoughtfully (Lipkus & Hollands, 1999)

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WhereWhere Should Risk Should Risk Communication Occur?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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