Meta-analysis of the relationship between risk perception and health behavior: the example of vaccination.

BACKGROUND: Risk perceptions are central to many health behavior theories. However, the relationship between risk perceptions and behavior, muddied by instances of inappropriate assessment and analysis, often looks weak. METHOD: A meta-analysis of eligible studies assessing the bivariate association between adult vaccination and perceived likelihood, susceptibility, or severity was conducted. RESULTS: Thirty-four studies met inclusion criteria (N = 15,988). Risk likelihood (pooled r = .26), susceptibility (pooled r = .24), and severity (pooled r = .16) significantly predicted vaccination behavior. The risk perception-behavior relationship was larger for studies that were prospective, had higher quality risk measures, or had unskewed risk or behavior measures. CONCLUSIONS: The consistent relationships between risk perceptions and behavior, larger than suggested by prior meta-analyses, suggest that risk perceptions are rightly placed as core concepts in theories of health behavior.     

Long-term effects of appearance-based interventions on sun protection behaviors.

OBJECTIVES: To examine the longer term efficacies of exposure to UV photographs and photoaging information (e.g., wrinkles and age spots) for increasing sun protection intentions and behaviors of young adults. DESIGN: Randomized controlled trial with 4- to 5-month and 12-month follow-ups. MAIN OUTCOME MEASURES: Participants' self-reported sun protection intentions assessed immediately after the interventions, and both self-reported sun protection behaviors and an objective assessment (via spectrophotometry) of skin color change measured at the end of summer (4-5 months following interventions) and 1 year following interventions. RESULTS: Both interventions resulted in immediate positive effects on future sun protection intentions. Both interventions showed objective evidence of less skin darkening at the postsummer follow-up, with those in the photoaging information condition also reporting more sun protective behavior and continuing to show less skin darkening 1 year after intervention. There was also evidence that effects of photoaging information on subsequent skin color change were mediated by the earlier positive effect photoaging information had on participants' intentions to sun protect and their subsequent sun protection behaviors. CONCLUSIONS: UV photo and photoaging-information interventions each show promise as a brief and relatively inexpensive approach for motivating sun protection practices that may reduce skin cancer risk.     

Examining Perceived Multicultural Counseling Competence and Negative Attitudes Toward the Arab American Population

The purpose of this quantitative study was to investigate the relationship between professional counselors’ general multicultural competence and negative attitudes held toward Arab Americans. Participants (N = 124) completed a survey, and a series of correlational, stepwise, and multiple regression analyses was conducted. Results indicated that counselors displayed higher levels of multicultural awareness than of multicultural knowledge. Furthermore, general multicultural awareness and specific knowledge of Arabs related significantly to negative attitudes held toward Arabs. El propósito de este estudio cuantitativo fue investigar la relación entre la competencia multicultural general de consejeros profesionales y las actitudes negativas mantenidas hacia personas estadounidenses de origen árabe. Los participantes (N = 124) completaron una encuesta, y se llevó a cabo una serie de análisis correlacionales, por pasos y de regresión múltiple. Los resultados indicaron que los consejeros mostraron niveles de conciencia multicultural mayores que los niveles de conocimiento multicultural. Además, la conciencia multicultural general y el conocimiento específico acerca de las personas árabes estuvieron significativamente relacionados con actitudes negativas mantenidas hacia personas árabes.     

Risk perceptions: assessment and relationship to influenza vaccination.

OBJECTIVE: Accurate measurement of beliefs about risk probability is essential to determine what role these beliefs have in health behavior. This study investigated the ability of several types of risk perception measures and of other constructs from health behavior theories to predict influenza vaccination. DESIGN: Prospective study in which students, faculty, and staff at 3 universities (N = 428) were interviewed in the fall, before influenza vaccine was available, and again early in the next calendar year. MAIN OUTCOME MEASURE: Self-reported influenza vaccination. RESULTS: Two interview questions that asked about feeling at risk and feeling vulnerable predicted subsequent behavior better (r = .44, p = .001) than 2 questions that asked for agreement or disagreement with statements about risk probability (r = .25, p = .001) or 4 questions that asked respondents to estimate the magnitude of the risk probability (r = .30, p = .001). Of the 4 perceived risk magnitude scales, a 7-point verbal scale was the best predictor of behavior. Anticipated regret was the strongest predictor of vaccination (r = .45, p = .001) of all constructs studied, including risk perceptions, worry, and perceived vaccine effectiveness. CONCLUSION: Risk perceptions predicted subsequent vaccination. However, perceived risk phrased in terms of feelings rather than as a purely cognitive probability judgment predicted better. Because neither feeling at risk nor anticipated regret is represented in the most commonly used theories of health behavior, the data suggest that these theories are missing important constructs.     

How personal standards perfectionism and evaluative concerns perfectionism affect the error positivity and post-error behavior with varying stimulus visibility

Error detection is required in order to correct or avoid imperfect behavior. Although error detection is beneficial for some people, for others it might be disturbing. We investigated Gaudreau and Thompson’s (Personality and Individual Differences, 48, 532?537, 2010) model, which combines personal standards perfectionism (PSP) and evaluative concerns perfectionism (ECP). In our electrophysiological study, 43 participants performed a combination of a modified Simon task, an error awareness paradigm, and a masking task with a variation of stimulus onset asynchrony (SOA; 33, 67, and 100 ms). Interestingly, relative to low-ECP participants, high-ECP participants showed a better post-error accuracy (despite a worse classification accuracy) in the high-visibility SOA 100 condition than in the two low-visibility conditions (SOA 33 and SOA 67). Regarding the electrophysiological results, first, we found a positive correlation between ECP and the amplitude of the error positivity (Pe) under conditions of low stimulus visibility. Second, under the condition of high stimulus visibility, we observed a higher Pe amplitude for high-ECP–low-PSP participants than for high-ECP–high-PSP participants. These findings are discussed within the framework of the error-processing avoidance hypothesis of perfectionism (Stahl, Acharki, Kresimon, Völler, & Gibbons, International Journal of Psychophysiology, 97, 153–162, 2015).     

Research report: A preliminary analysis of medical futility decisionmaking: law and professional attitudes

Judicial decisions reviewed in this article indicate that courts have taken two disparate approaches to disputes over futility of treatment. To explore whether a consensus on medical futility is developing among hospitals, the authors conducted a nationwide survey of health care professionals at hospitals. Respondents assigned importance ratings to factors used in recent futility decisions made at their institutions. The resulting importance ratings showed significant variation by characteristics of the institution (comparing respondents from for-profit, not-for-profit, and government hospitals) and by profession of the respondent (comparing physicians and nurses). The respondents' judgments endorsed three distinct strategies for making futility decisions (i.e., emphasis on the patient's decision preferences, providing for the patient and family, and adhering to objective medical and social norms). © 1998 John Wiley & Sons, Ltd.     

Accentuate the Negative: Social Images in the Prediction and Promotion of Condom Use1

Based on the negativity bias in person perception, we argue that behavioral decisions related to condom use are influenced by the social images that an individual has of people who do not use condoms, but that they are not influenced by the social images that an individual has of people who do use condoms. Three studies with college student samples indicated that the negative evaluations of people who do not use condoms predicts willingness to have sex without condoms. In contrast, positive evaluations of people who do use condoms showed no unique predictions. A fourth study demonstrated that a health message emphasizing the negative social consequences of having sex without condoms decreased willingness to have unsafe sex in comparison to a control, whereas a message that emphasized the positive social consequences of using condoms had no such effects on willingness.