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.