Abstract: One of the understudied topics in risk communication is why individuals do not follow or are resistant to recommended behaviors that optimize personal health outcomes. To understand the dimensionality of these responses, this study investigates barriers for persuasion (i.e., risk tolerance and message fatigue) and trust in government. An online survey using a representative adult sample (n = 510) in Australia was conducted. Key findings include: 1) Greater trust in government lowers the level of risk tolerance; 2) Lowered risk tolerance mediates between greater trust in government and behavioral intention to be more risk preventive; 3) Lowered risk tolerance mediates between greater trust in government and risk preventive information seeking; 4) Greater trust decreases health risk message fatigue; and 5) Lower level of health risk message fatigue mediates between greater trust in government and risk preventive behavioral intention. Implications and future directions for health risk communication theory and practice are discussed.
Hyoyeun Jun (Grady PhD Alum) and Yan Jin (Forthcoming). “The Conceptualization of Risk Tolerance and Scale Development for Measuring Publics’ Tolerance of Individual Health Risks.” Journal of International Crisis and Risk Communication Research.
Abstract: Risk tolerance, identified by scholars over two decades ago as an essential concept in risk communication, has remained understudied without clear conceptual and operational definitions. As the first study developing a multiple-item scale for measuring at-risk publics’ tolerance of different risk types, this study refines the conceptualization of risk tolerance and advances its operationalization in the setting of individual health risks. Qualitative research (in-depth interviews: n=28; focus group: n=30) and two survey datasets (sample 1: n=500; sample 2: n=500) were employed for scale development and testing. Results identify that two types of individual health risk tolerance exhibited by at-risk publics: 1) Compulsive tendency toward risk taking (CTRT), as evidenced in their unwillingness to refrain from risky behaviors even if they know the negative consequences; and 2) Inertial resistance to risk prevention (IRRP), as indicated by their indifference toward or intentionally ignoring health messages advocating for behavioral changes. The two-factor 13-item scale’s reliability, factorial structure, and validity are further assessed. This risk tolerance scale provides a valid and reliable psychometric tool for risk communication scholars and practitioners to measure publics’ tolerance of different individual health risks in order to design effective messages to overcome it as a barrier.
Hargreaves AL, Glen J. Nowak, Paula Frew, AR Hinman, WA Orenstein et al., “Adherence to Timely Vaccinations in the United States,” Pediatrics, 145(3, March 2020):e20190783.
Abstract: We used 2014 National Immunization Survey provider-verified vaccination data to classify vaccination patterns as “recommended” (ie, in line with ACIP dose- and age-specific
recommendations), “alternate” (ie, in line with either limiting the number of shots per visit or skipping at least 1 vaccine series), or “unknown or unclassifiable” (i.e., not in line with ACIP recommendations or clearly limiting shots per visit or vaccine series). The majority of children’s patterns were classified as “recommended” (63%), with 23% and 14% following alternate or unknown or unclassifiable patterns, respectively; 58% of children were up-to-date with all ACIP-recommended immunizations by 19 to 35 months. Not being up-to-date was associated with alternate and unknown or unclassifiable patterns.
Boyle J., Berman L, Glen J. Nowak, Iachan R, Middleton D and Deng Y. “An Assessment of Parents’ Childhood Immunization Beliefs, Intentions, and Behaviors Using a Smartphone Panel,” Vaccine, 2020;38(10):2416-2423.
Abstract: It is important to quickly identify parent beliefs, intentions, and behaviors toward childhood vaccination, especially parents of children 19 to 35 months. A sample of parents, ages 18 and older, from a mobile panel with people residing in the U.S. were invited to answer immunization behavior, intention, and belief questions using a smartphone app that was not vaccine specific. This survey provided insights into beliefs and behaviors of parents regarding childhood vaccination. It found evidence of differences in beliefs, particularly related to delaying or declining recommended childhood vaccinations. The survey was conducted in a few days and at lower cost than traditional methods.
Glen Nowak, Michael Cacciatore, Bart Wojdynski, Glenna Read, and Itai Himelboim are part of a University of Georgia proposal submitted in response to a National Institutes of Health call for proposals to establish Centers of Excellence for Influenza Research and Response (CIERR). As part of UGA’s proposal to establish a UGA Center for Influenza Disease and Emergence Research (CIDER), the Grady College Center for Health & Risk Communication could receive approximately $2,352,975 to undertake survey, message and material testing involving eye-tracking and psychophysiological measures, and social media monitoring-related research related to pandemic influenza beliefs and intentions over the course of seven years. The overall UGA contract proposal is approximately $57 million for the seven-year period.
Accepted for presentation at the International Crisis and Risk Communication Conference (ICRCC), March 9-11, 2020, Orlando, FL.
Abstract: How to detect side effects of repeated exposure of the same or similar campaign messages over time on at-risk publics has emerged as a critical research question currently understudied. By formulating a new way of assessing health risk communication effect via the chemical analogy of 1) concentration (i.e., strategy) and 2) dosage (Johnson, 2008), our conceptual model provides a foundation for understanding how both strategy and dosage of a health message can exert (un)intended effects among at-risk publics.
Abstract: To estimate 1) the proportion of children not adhering to the Advisory Committee on Immunization Practices (ACIP) recommended early childhood immunization schedule and 2) associations between schedule adherence, sociodemographic characteristics and up-to-date immunization status by 19-35 months of age. Methods: We used 2014 National Immunization Survey (NIS) provider-verified vaccination data to classify vaccination patterns as “recommended” (i.e., in line with ACIP dose- and agespecific recommendations), “alternate” (i.e., in line with either limiting the number of shots per visit or skipping at least one vaccine series) or “unknown/unclassifiable” (i.e., not in-line with ACIP recommendations nor clearly limiting shots per visit or vaccine series). We evaluated predictors of immunization schedule adherence patterns and estimated the association between vaccination patterns and up-to-date status for all ACIP-recommended vaccinations (including rotavirus and hepatitis A vaccines) using Poisson regression. Results: The majority of children’s patterns were classified as “recommended” (63%), with 23% and 14% following alternate or unknown/unclassifiable patterns, respectively; 58% of children were up-to-date with all ACIP-recommended immunizations by 19-35 months. Not being up-to-date was associated with alternate (prevalence ratio [PR] = 4.2, 95% confidence interval [CI] 3.9, 4.5) and unknown/unclassifiable (PR = 2.4, 95% CI 2.2, 2.7) vaccination patterns. Conclusion: Overall high vaccine coverage by 19-35 months of age may miss non-adherence to the recommended immunization schedule in the first 18 months of life, leaving children vulnerable to preventable diseases. With more than one-third of US children not following the ACIP schedule, targeted interventions are needed to minimize vaccine delays and disease susceptibility.
Abstract: To develop a Vaccine Confidence Index (VCI) that is capable of detecting variations in parental confidence towards childhood immunizations centered on trust and concern issues that impact vaccine confidence. Methods: We used a web-based national poll of 893 parents of children <7 years in 2016 to assess the measures created for the Emory VCI (EVCI). EVCI measures were developed using constructs related to vaccine confidence identified by the U.S. National Vaccine Advisory Committee (i.e., “Information Environment”, “Trust”, “Healthcare Provider”, “Attitudes and Beliefs”, and “Social Norms”). Reliability for EVCI was assessed using Cronbach’s alpha. Using the variables related to each of the constructs, we calculated an overall EVCI score that was then assessed against self-reported childhood vaccine receipt using chi-square and the Cochrane-Armitage trend tests. Results: Respondents’ EVCI scores could range from 0 to 24, and the full range of values was observed in this sample (Mean = 17.5 (SD 4.8)). EVCI scores were significantly different (p ≤ 0.006 for all comparisons) between parents who indicated their child(ren) received routinely recommended vaccines compared with parents who indicated they had delayed or declined recommended immunizations. There was also a significant, consistent association between higher EVCI scores and greater reported vaccine receipt. Conclusions: We developed EVCI to reliably measure parental vaccine confidence, with individuals’ scores linked to parental vaccine-related attitudes, intentions, and behaviors. As such, EVCI may be a useful tool for future monitoring of both population and individual confidence in childhood immunization.
Abstract: Vaccines that would be recommended and offered in response to a novel influenza virus bring many communication challenges. This chapter identifies and describes some of the major issues that public health agencies and regulatory bodies, vaccine manufacturers, and healthcare professionals would face when it comes to pandemic influenza vaccines and immunization recommendations. It does so by drawing upon experiences, findings, and outcomes from the H1N1A influenza pandemic in 2009 that affected much of the world as well as lessons learned from annual influenza prevention efforts. It begins with challenges due to uncertainties and complexities brought by influenza viruses and then highlights experiences from different countries with a focus on France as a relevant example, illustrating the similarities and differences that can affect pandemic influenza vaccine communication. The final section of the chapter reflects on some key communication-related research findings as well as lessons learnt that can help guide those doing vaccination-related communication responses and efforts in future influenza pandemics.
Abstract: Given their influence and visibility, understanding how news media cover topics involving medicines and how they provide information to their target audiences is essential when it comes to medicinal product risk communication research. While information about health and medicine are found in entertainment and social media, this chapter introduces media science with a focus, albeit not exclusively, on journalist-based news media. It presents an overview of relevant theories as well as methods that academics, government agencies, professional societies and pharmaceutical companies can use to understand communication flows in the media and their potential effects. Particularly, it reviews in more depth, the methodological aspects of content analyses as well as discusses research approaches, including those involving journalists, which could be used to guide or strengthen medicinal product risk communication. Media science-based research can inform the preparations of communication strategies and materials; and studying what is actually happening in the news media is relevant to establishing communication models and evaluating communication interventions in a rapidly changing media landscape.