Fear-Mongering or Fact-Driven? Illuminating the Interplay of Objective Risk and Emotion-Evoking Form in the Response to Epidemic News

Associations between empirically proportionate and disproportionate fears of cancer recurrence and anxiety and depression in uveal melanoma survivors: Five-year prospective study

OBJECTIVE

Fear of cancer recurrence (FCR) may develop into elevated anxiety or depression symptoms, but few risk factors for this development are known. Objective recurrence risk estimation is possible in some cancers. Using theories of risk communication and phobias, we examined whether the proportionality of FCR to known objective recurrence risk influences the development of anxiety and depression symptoms.

METHOD

Uveal melanoma (UM) patients can opt for reliable prognostic testing. Patients experience either a 'good' or 'poor' prognostic outcome, whereby 10-year mortality due to metastatic disease is, respectively, low or high. In a five-year prospective study of a consecutive sample of 589 UM survivors, we used random intercept cross lagged panel analyses to examine whether proportionality differentially influences whether FCR progresses to anxiety and depression.

RESULTS

Positive cross paths predicting anxiety from FCR were stronger in the poor prognosis group than the good prognosis and not tested groups. Prognostic group differences were not evident for depression.

CONCLUSIONS

FCR was more likely to progress to elevated anxiety symptoms when proportionate to the known objective recurrence risk. Objective evidence may play a prominent role in the development and structure of fear because it assumes a high epistemic weight that activates a wide range of emotional and cognitive responses. Interventions that assist survivors to tolerate FCR in the presence of higher recurrence risks may be important in reducing anxiety symptoms.

Effects of Scanning Health News Headlines on Trust in Science: An Emotional Framing Perspective

Rooted in the emotions-as-frames model (EFM), this research examines how hope, fear, and annoyance are evoked through health news headline scanning, and how these emotions influence perceptions of news and medical science institutions as well as health behavioral intentions. A sample of U.S. adults (N = 327) were assigned to one of four headline framing conditions expected to associate with different emotions (positive future frame-hope; threat frame-fear/anxiety; reversal frame-annoyance; and control-neutral) and then asked about their emotional states, trust in science and news, and health-related behavioral intentions. Overall, health news headlines generated more hope than any other emotion across all conditions, and positive future-framed headlines evoked more hope than other framed headlines. Felt hope, in turn, generated greater trust in news and science, higher expectations of medical breakthroughs and cures, and greater intention to engage in preventative health behaviors. Felt anxiety had marginal positive benefits whereas felt annoyance negatively impacted the outcomes of interest. Notably, felt emotion mediated the headline frame-outcome relationships in the positive future/hope condition. These findings offer some support for the EFM and demonstrate that scanning headlines imbued with specific emotional frames can influence important health-related outcomes through the emotions they evoke. We discuss both the theoretical and practical implication of these findings.

Words and numbers: a comparative study of medical and journalism students' descriptors of risk, numeracy and preferences for health risk communication

BACKGROUND

Given the complementary roles of health professionals and journalists in communicating health risks to patients and the public, there have been calls for physicians to work with journalists to improve the quality of health information received by the public. Understanding the preferences of medical and journalism students for the way in which health risks are communicated and their understanding of words used to describe risk is an important first step to inform interdisciplinary learning.

METHODS

Medical and journalism students (n = 203) completed an online survey where they were given qualitative descriptors of risk such as 'a chance', 'probably' and 'unlikely', and asked to assign a number that represents what the word means to them. Different formats of communicating risk (percentages, natural frequency and visual aids) were provided and students were asked to select and explain their preference. A thematic analysis of reasons was conducted. Numeracy and perceived mathematics ability were measured.

RESULTS

Numbers assigned to the descriptor 'A chance' had the highest variability for medical students. Numbers assigned to the descriptor 'Probably' had the highest variability for journalism students. Using visual aids was the most popular format for risk communication for both courses (56% of medical students and 40% of journalism students). Using percentages was twice as popular with journalism students compared to medical students (36% vs. 18%). Perceived mathematics ability was lower in students with a preference for natural frequencies and in journalism students, however performance on an objective numeracy scale was similar for all three formats (percentages, natural frequency and visual aids). Reasons for choosing a preferred format included good communication, eliciting a response, or learning style.

CONCLUSIONS

Education on health risk communication for medical and journalism students should emphasize the need for qualitative descriptors of risk to be combined with the best available number. Students are already considering their role as future communicators of health risks and open to tailoring the mode of presentation to their audience. Further research is required on the design and evaluation of interdisciplinary workshops in health risk communication for medical and journalism students to maximise the opportunities for future inter-professional working.

Selfie-Related Incidents: Narrative Review and Media Content Analysis

BACKGROUND

Selfie-related injury has become a public health concern amid the near ubiquitous use of smartphones and social media apps. Of particular concern are selfie-related deaths at aquatic locations; areas often frequented because of their photogenic allure. Unfortunately, such places exhibit hazards inherent with their environment.

OBJECTIVE

This study aimed to ascertain current evidence regarding selfie-related injuries and recommended risk treatment measures in the academic literature as well as how selfie-related injuries and deaths were being reported by the media, allowing us to identify key challenges facing land managers and public health practitioners in mitigating selfie-related injuries and deaths.

METHODS

Between October and December 2022, we performed a narrative review of peer-reviewed literature published since January 2011. Literature was screened to identify causal factors implicated in selfie-related deaths and injuries, as well as risk treatments recommended. Furthermore, we used an environmental scan methodology to search for media reports of selfie-related injuries and deaths at aquatic locations in Australia and the United States. Individual cases of selfie-related aquatic injuries and deaths sourced from news reports were analyzed to assess epidemiological characteristics, and a thematic content analysis was conducted to identify key themes of news reporting on selfie-related deaths and injuries.

RESULTS

In total, 5 peer-reviewed studies were included. Four studies identified falls from height as the most common injury mechanism in selfie incidents. Drowning was the second most common cause of death. Recommended risk treatments were limited but included the adoption of "no selfie zones," physical barriers, signage, and provision of information on dangerous locations to social media users. In total, 12 cases were identified from media reports (4 injuries and 8 fatalities; 7 in Australia and 5 in the United States). The mean age of the reported victims was 22.1 (SD 6.93) years with victims more likely to be female tourists. Content analysis revealed 3 key themes from media reports: "blame," "warning," and "prevention and education." Few media reports (n=8) provided safety recommendations.

CONCLUSIONS

The selfie-related incident phenomenon should be viewed as a public health problem that requires a public health risk communication response. To date, little attention has been paid to averting selfie-related incidents through behavior change methodologies or direct messaging to users, including through social media apps. Although previous research has recommended "no selfie zones," barriers, and signage as ways to prevent selfie incidents, our results suggest this may not be enough, and it may be prudent to also engage in direct safety messaging to social media users. Media reporting of selfie incidents should focus on preventive messaging rather than blame or warning.

Evolution Model and Simulation Study of the Public Risk Perception of COVID-19

The evolution of the public perception of the risk in public health emergencies is closely related to risk response behavior. There are few systematic explanations and empirical studies on how the individual receiving the risk information affects the change in the individual risk perception through internal mechanisms in the context of COVID-19. Based on the understanding of the existing research, this paper constructs the evolution model of the public risk perception level based on the limited memory theory and a simulation analysis is performed. The results are as follows: memory rate, association rate, information reception and information stimulation in a single period of time have significant indigenous effects on the risk perception; when the amount of information received and the information stimulus remain unchanged, the public's risk perception follows a monotonic upward trend, but there is an upper limit function, and the upper limit is determined by the memory rate and association rate, and the influence of the association rate is higher than that of the memory rate; When the amount of information received and the information stimulus changes, the public's risk perception will also change, and there is a lag effect, which is determined by the memory rate. The impact of the acceptance of the information on the risk perception is greater than that of the information stimulus.

Cognitive and Affective Routes to the Adoption of Protective Behaviors Against Health Risks of PM2.5 in China

The current research examines how risk appraisals of PM2.5 influence Chinese people's behavioral intentions to adopt government-recommended protective behaviors through negative affect. In testing the appraisal-based protective behavior model, this research also takes institutional trust and media sensationalism into account. An online survey is conducted with participants (N = 1,569) randomly drawn from heavily polluted Chinese regions. As predicted, negative affect mediates the effects of perceived susceptibility and perceived severity on individuals' intentions to take preventive measures against the PM2.5 risk. Institutional trust appears to increase people's behavioral intentions. However, media sensationalism decreases people's behavioral intentions.

Dynamics in public perceptions and media coverage during an ongoing outbreak of meningococcal W disease in the Netherlands

Background

From 2015 to 2018, the Netherlands faced an outbreak of invasive meningococcal disease (IMD) caused by serogroup W. To counter the rise in infections, the government introduced a catch-up menACWY vaccination campaign for teenagers in 2018 and 2019. The outbreak situation induced substantial media attention and a run on menACWY vaccines outside the vaccination campaign. This study aimed to gain insights into the dynamics of public perceptions of and responses to the outbreak and the menACWY vaccination, and into the media coverage about the outbreak.

Methods

Three repeated surveys (N = 1110) between 2017 and 2019 were sent to parents of teenagers invited for a menACWY catch-up vaccination, other parents, and individuals with no under-age children. These surveys assessed IMD risk perceptions, attitudes towards the menACWY vaccination, trust in involved institutions, and willingness to vaccinate with the menACWY vaccine. Changes in the public perceptions and responses were studied with linear multilevel regression analyses. In addition, 103 national newspaper articles from the period 2017–2019 were thematically coded with themes about IMD and the menACWY vaccination.

Results

The survey results showed clear increases in perceived IMD severity, positive attitude towards the menACWY vaccination, and willingness to vaccinate over time. Perceived IMD vulnerability remained low across all three waves, and trust in involved institutions increased slightly. Differences between the survey groups were limited. The newspaper articles discussed the rise in infections extensively, the disease symptoms, and the possible fatal outcome of IMD. In addition, while many articles discussed the menACWY vaccine shortage, few discussed the safety or effectiveness of the vaccine.

Conclusion

The real-time insights into the interrelated dynamics of public perceptions, responses, and media coverage provide an integrated portrait of the social developments during this outbreak. The focus on IMD severity and the absence of doubt in the public discussion about vaccine safety may have played an important role in the societal response to this outbreak and the recommended vaccine.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12920-8.

When danger strikes: A linguistic tool for tracking America's collective response to threats

In today's vast digital landscape, people are constantly exposed to threatening language, which attracts attention and activates the human brain's fear circuitry. However, to date, we have lacked the tools needed to identify threatening language and track its impact on human groups. To fill this gap, we developed a threat dictionary, a computationally derived linguistic tool that indexes threat levels from mass communication channels. We demonstrate this measure's convergent validity with objective threats in American history, including violent conflicts, natural disasters, and pathogen outbreaks such as the COVID-19 pandemic. Moreover, the dictionary offers predictive insights on US society's shifting cultural norms, political attitudes, and macroeconomic activities. Using data from newspapers that span over 100 years, we found change in threats to be associated with tighter social norms and collectivistic values, stronger approval of sitting US presidents, greater ethnocentrism and conservatism, lower stock prices, and less innovation. The data also showed that threatening language is contagious. In all, the language of threats is a powerful tool that can inform researchers and policy makers on the public's daily exposure to threatening language and make visible interesting societal patterns across American history.

The role of the media in the amplification of a contested health risk: Rubber granulate on sport fields

This study aims to increase insights into the potential role of the media in the amplification and attenuation of modern risks in society, by studying the dynamics and contents of the newspaper coverage about the potential health risk posed by rubber granulate in the Netherlands. We thematically analysed 153 national newspaper articles about the risks posed by rubber granulate between September 2016 and February 2017. Our results suggest that newspaper coverage might have contributed to heightened public risk perceptions by presenting the negligible health risk as uncertain, focusing on controversy between authorities and experts, describing responses such as concerns, commotion, and adopted risk mitigation measures by members of the public, and by providing insufficient contextualization on whether hazardous substances in rubber granulate pose a threat to health. The risks posed by rubber granulate is one of the many modern risks that has become subject to heated and mediated public discussions. Our results provide in-depth insights into important content elements in media coverage during such discussions and the impact of these elements on public perceptions. Public health institutes and other authorities might be able to mitigate the amplification of risks through media coverage by means of appropriate preparedness and response.

They promised this ten years ago. Effects of diabetes news characteristics on patients' perceptions and attitudes towards medical innovations and therapy adherence

Patients have ever-increasing access to web-based news about hopeful scientific developments that may or may not cure them in the future. Science communication experts agree that the quality of news provision is not always guaranteed. However, literature does not clarify in what way users are actually affected by typical news characteristics such as the news object (described developmental phase of an innovation), the news source (degree of authority), and the news style (degree of language intensification). An online vignette experiment (N = 259) investigated causal relationships between characteristics of news about diabetes innovations and patients’ perceptions of future success, their interest in the innovation, and attitudes regarding current therapy adherence. Findings show that descriptions of success in mice led to higher estimations of future success chances than earlier and later developmental phases. Furthermore, news from a nonauthoritative source led to an increased interest in the innovation, and a more negative attitude towards current lifestyle advice. Lastly, the intensification of the language used in news messages showed slight adverse effects on the readers’ attitude. These findings, combined with their small effect sizes, support the optimistic view that diabetes patients are generally critical assessors of health news and that future research on this topic should focus on affected fragile subgroups.

A nationwide evaluation of the prevalence of and risk factors associated with anxiety, depression and insomnia symptoms during the return-to-work period of coronavirus disease 2019 in China

PURPOSE

To evaluate the prevalence of and risk factors associated with anxiety, depression, and insomnia symptoms during the return-to-work period of coronavirus disease 2019 in China.

METHODS

The authors conducted a large-scale, nationwide, multicenter, cross-sectional study in China. A population-based quota and snowball sampling were designed to recruit a representative sample. Online questionnaires and telephone reviews were used to collect characteristics and assess psychological and sleep problems. Anxiety, depression, and insomnia symptoms were measured by the generalized anxiety disorder-7, patient health questionnaire-9, and insomnia severity index tools.

RESULTS

A total of 42,000 participants were recruited from 15 centers, and 36,795 valid questionnaires were received. Generally, 18.3, 14.9, and 17.9% of the participants had anxiety, depression, and insomnia symptoms, respectively, and 2.2-2.7% had severe symptoms. Engaging in outside activity once in ≥ 30 days (OR = 2.719, OR = 2.074, OR = 2.225) and age 50-64 years (OR = 2.431, OR = 1.936, OR = 2.036) were common risk factors for anxiety, depression and insomnia symptoms. Living in Hubei Province (OR = 1.304, OR = 1.242) was a common risk factor for anxiety and insomnia symptoms. Working as frontline medical staff (OR = 2.150) was another risk factor for anxiety symptoms. The health education rate of the samples reached 98.9%. However, the psychological intervention rate was only 16.2%, and 2.5% received targeted interventions.

CONCLUSIONS

An increasing number of people might have psychological and sleep problems. However, the current psychological interventions are not sufficient. Efforts should be made to strengthen interventions for high-risk populations.

Effect of Income Level and Perception of Susceptibility and Severity of COVID-19 on Stay-at-Home Preventive Behavior in a Group of Older Adults in Mexico City

Early information on public health behaviors adopted to prevent the spread of coronavirus (COVID-19) may be useful in controlling the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) transmission. The objective of this study was to assess the role of income level (IL) and the perception of older adults, regarding COVID-19 susceptibility and severity, on adopting stay-at-home preventive behavior during the first week of the outbreak in Mexico. Participants in this cross-sectional study were urban community dwellers, aged ≥ 65 years from Mexico City. A total of 380 interviews were conducted over the phone. The mean respondent age was 72.9 years, and 76.1% were women. Over half (54.2%) of the participants perceived their susceptibility to COVID-19 as very low or low. Similarly, 33.4% perceived COVID-19 severity as being very low or low, and 57.6% had decided to stay at home: this behavior was associated with IL (β = 1.05, p < 0.001), and its total effect was partially mediated (15.1%) by perceived severity. Educational attainment was also associated with staying at home (β = 0.10, p = 0.018) and its total effect was partially mediated (15.0%) by perceived susceptibility. Interventions aimed at low income and less educated older adults should be developed to improve preventive behaviors in this vulnerable group during the COVID-19 pandemic.