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Okan Y, Stone ER, Parillo J, Bruine de Bruin W, Parker AM. Probability Size Matters: The Effect of Foreground-Only versus Foreground+Background Graphs on Risk Aversion Diminishes with Larger Probabilities. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2020; 40:771-788. [PMID: 31907975 DOI: 10.1111/risa.13431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 11/04/2019] [Accepted: 11/16/2019] [Indexed: 06/10/2023]
Abstract
Graphs are increasingly recommended for improving decision-making and promoting risk-avoidant behaviors. Graphs that depict only the number of people affected by a risk ("foreground-only" displays) tend to increase perceived risk and risk aversion (e.g., willingness to get vaccinated), as compared to graphs that also depict the number of people at risk for harm ("foreground+background" displays). However, previous research examining these "foreground-only effects" has focused on relatively low-probability risks (<10%), limiting generalizability to communications about larger risks. In two experiments, we systematically investigated the moderating role of probability size on foreground-only effects, using a wide range of probability sizes (from 0.1% to 40%). Additionally, we examined the moderating role of the size of the risk reduction, that is, the extent to which a protective behavior reduces the risk. Across both experiments, foreground-only effects on perceived risk and risk aversion were weaker for larger probabilities. Experiment 2 also revealed that foreground-only effects were weaker for smaller risk reductions, while foreground-only displays decreased understanding of absolute risk magnitudes independently of probability size. These findings suggest that the greater effectiveness of foreground-only versus foreground+background displays for increasing perceived risk and risk aversion diminishes with larger probability sizes and smaller risk reductions. Moreover, if the goal is to promote understanding of absolute risk magnitudes, foreground+background displays should be used rather than foreground-only displays regardless of probability size. Our findings also help to refine and extend existing theoretical accounts of foreground-only effects to situations involving a wide range of probability sizes.
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Affiliation(s)
- Yasmina Okan
- Centre for Decision Research, Leeds University Business School, University of Leeds, Leeds, UK
| | - Eric R Stone
- Department of Psychology, Wake Forest University, Winston-Salem, NC, USA
| | - Jonathan Parillo
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Wändi Bruine de Bruin
- Centre for Decision Research, Leeds University Business School, University of Leeds, Leeds, UK
- Department of Engineering and Public Policy, Carnegie Mellon University, Pittsburgh, PA, USA
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2
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Jin C, Bao J, Wang Y, Chen W, Zou S, Wu T, Wang L, Lv X, Gao W, Wang B, Zhu G, Dai G, Shi D, Sun W. Changes in circRNA expression profiles related to the antagonistic effects of Escherichia coli F17 in lamb spleens. Sci Rep 2018; 8:14524. [PMID: 30266913 PMCID: PMC6162294 DOI: 10.1038/s41598-018-31719-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 08/17/2018] [Indexed: 12/27/2022] Open
Abstract
Sheep colibacillosis is one of the most common bacterial diseases in large-scale sheep farms. In this study, we orally administered Escherichia coli F17 (E. coli F17) to lambs to obtain antagonistic and sensitive individuals. We used RNA-seq to screen for differential circRNAs in the spleens of both antagonist and sensitive individuals to explore the effect of circRNA on anti-diarrhoea in sheep. The results showed that 60 differentially expressed (DE) circRNAs were screened by RNA-seq in the spleen of antagonistic and sensitive lambs, among which 31 were up-regulated and 29 were down-regulated; q-PCR was used to validate the relative expression levels of six randomly selected circRNAs in antagonist and susceptible lambs and found to be consistent with the results of RNA-seq. Using Miranda analysis of circRNA-miRNA-mRNA interactions, we found a certain target relationship between 6 circRNAs, 5 miRNAs and 9 mRNAs. The relative expression levels of mRNA in antagonistic and sensitive lambs were verified by q-PCR and were consistent with the results of RNA-seq. This study explored the expression profile of circRNA in the spleen of an antagonistic and susceptible lamb with diarrhoea and found that differentially expressed circRNAs were helpful for determining how the lambs resist the pathogenesis of diarrhoea and provided a scientific basis for lambs to resist diarrhoea.
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Affiliation(s)
- Chengyan Jin
- Key Laboratory for Animal Genetics, Breeding, Reproduction and Molecular Design of Jiangsu Province, College of Animal Science and Technology, Yangzhou University, Yangzhou, 225009, Jiangsu, P. R. China
| | - Jianjun Bao
- Key Laboratory for Animal Genetics, Breeding, Reproduction and Molecular Design of Jiangsu Province, College of Animal Science and Technology, Yangzhou University, Yangzhou, 225009, Jiangsu, P. R. China
| | - Yue Wang
- Key Laboratory for Animal Genetics, Breeding, Reproduction and Molecular Design of Jiangsu Province, College of Animal Science and Technology, Yangzhou University, Yangzhou, 225009, Jiangsu, P. R. China
| | - Weihao Chen
- Key Laboratory for Animal Genetics, Breeding, Reproduction and Molecular Design of Jiangsu Province, College of Animal Science and Technology, Yangzhou University, Yangzhou, 225009, Jiangsu, P. R. China
| | - Shuangxia Zou
- Key Laboratory for Animal Genetics, Breeding, Reproduction and Molecular Design of Jiangsu Province, College of Animal Science and Technology, Yangzhou University, Yangzhou, 225009, Jiangsu, P. R. China
| | - Tianyi Wu
- Key Laboratory for Animal Genetics, Breeding, Reproduction and Molecular Design of Jiangsu Province, College of Animal Science and Technology, Yangzhou University, Yangzhou, 225009, Jiangsu, P. R. China
| | - Lihong Wang
- Key Laboratory for Animal Genetics, Breeding, Reproduction and Molecular Design of Jiangsu Province, College of Animal Science and Technology, Yangzhou University, Yangzhou, 225009, Jiangsu, P. R. China
| | - Xiaoyang Lv
- Key Laboratory for Animal Genetics, Breeding, Reproduction and Molecular Design of Jiangsu Province, College of Animal Science and Technology, Yangzhou University, Yangzhou, 225009, Jiangsu, P. R. China
| | - Wen Gao
- Key Laboratory for Animal Genetics, Breeding, Reproduction and Molecular Design of Jiangsu Province, College of Animal Science and Technology, Yangzhou University, Yangzhou, 225009, Jiangsu, P. R. China
| | - Buzhong Wang
- Jiangsu Xilaiyuan Ecological Agriculture Co., Ltd. Taizhou, Taizhou, 225300, Jiangsu, P. R. China
| | - Guoqiang Zhu
- College of Veterinary Medicine, Yangzhou University, Yangzhou, 225009, Jiangsu, P. R. China
| | - Guojun Dai
- Key Laboratory for Animal Genetics, Breeding, Reproduction and Molecular Design of Jiangsu Province, College of Animal Science and Technology, Yangzhou University, Yangzhou, 225009, Jiangsu, P. R. China
| | - Dongfang Shi
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, 150030, P. R. China
| | - Wei Sun
- Key Laboratory for Animal Genetics, Breeding, Reproduction and Molecular Design of Jiangsu Province, College of Animal Science and Technology, Yangzhou University, Yangzhou, 225009, Jiangsu, P. R. China.
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Okan Y, Stone ER, Bruine de Bruin W. Designing Graphs that Promote Both Risk Understanding and Behavior Change. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2018; 38:929-946. [PMID: 28973820 DOI: 10.1111/risa.12895] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 07/25/2017] [Accepted: 08/01/2017] [Indexed: 06/07/2023]
Abstract
Graphs show promise for improving communications about different types of risks, including health risks, financial risks, and climate risks. However, graph designs that are effective at meeting one important risk communication goal (promoting risk-avoidant behaviors) can at the same time compromise another key goal (improving risk understanding). We developed and tested simple bar graphs aimed at accomplishing these two goals simultaneously. We manipulated two design features in graphs, namely, whether graphs depicted the number of people affected by a risk and those at risk of harm ("foreground+background") versus only those affected ("foreground-only"), and the presence versus absence of simple numerical labels above bars. Foreground-only displays were associated with larger risk perceptions and risk-avoidant behavior (i.e., willingness to take a drug for heart attack prevention) than foreground+background displays, regardless of the presence of labels. Foreground-only graphs also hindered risk understanding when labels were not present. However, the presence of labels significantly improved understanding, eliminating the detrimental effect of foreground-only displays. Labels also led to more positive user evaluations of the graphs, but did not affect risk-avoidant behavior. Using process modeling we identified mediators (risk perceptions, understanding, user evaluations) that explained the effect of display type on risk-avoidant behavior. Our findings contribute new evidence to the graph design literature: unlike what was previously feared, we demonstrate that it is possible to design foreground-only graphs that promote intentions for behavior change without a detrimental effect on risk understanding. Implications for the design of graphical risk communications and decision support are discussed.
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Affiliation(s)
- Yasmina Okan
- Centre for Decision Research, Leeds University Business School, University of Leeds, UK
| | - Eric R Stone
- Department of Psychology, Wake Forest University, Winston-Salem, NC, USA
| | - Wändi Bruine de Bruin
- Centre for Decision Research, Leeds University Business School, University of Leeds, UK
- Department of Engineering and Public Policy, Carnegie Mellon University, Pittsburgh, PA, USA
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Stone ER, Reeder EC, Parillo J, Long C, Walb L. Salience Versus Proportional Reasoning: Rethinking the Mechanism Behind Graphical Display Effects. JOURNAL OF BEHAVIORAL DECISION MAKING 2018. [DOI: 10.1002/bdm.2051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | | | | | - LeeAnn Walb
- Wake Forest University; Winston-Salem NC USA
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Waters EA, Ball L, Gehlert S. "I don't believe it." Acceptance and skepticism of genetic health information among African-American and White smokers. Soc Sci Med 2017; 184:153-160. [PMID: 28527373 PMCID: PMC5535773 DOI: 10.1016/j.socscimed.2017.04.053] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 04/07/2017] [Accepted: 04/29/2017] [Indexed: 12/11/2022]
Abstract
RATIONALE Effective translation of genomics research into practice depends on public acceptance of genomics-related health information. OBJECTIVE To explore how smokers come to accept or reject information about the relationship between genetics and nicotine addiction. METHODS Thirteen focus groups (N = 84) were stratified by education (seven < Bachelor's degree, six ≥ Bachelor's degree) and race (eight black, five white). Participants viewed a 1-min video describing the discovery of a genetic variant associated with increased risk of nicotine addiction and lung cancer. Next, they provided their opinions about the information. Two coders analyzed the data using grounded theory. RESULTS Pre-video knowledge about why people smoke cigarettes and what genetic risk means informed beliefs about the relationship between genes and addiction. These beliefs were not always consistent with biomedical explanations, but formed the context through which participants processed the video's information. This, in turn, led to information acceptance or skepticism. Participants explained their reactions in terms of the scientific merits of the research and used their existing knowledge and beliefs to explain their acceptance of or skepticism about the information. CONCLUSION Laypeople hold complex understandings of genetics and addiction. However, when lay and biomedical explanations diverge, genetics-related health information may be rejected.
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Yuan XP, Liu LS, Chen CB, Zhou J, Zheng YT, Wang XP, Han M, Wang CX. MicroRNA-423-5p facilitates hypoxia/reoxygenation-induced apoptosis in renal proximal tubular epithelial cells by targeting GSTM1 via endoplasmic reticulum stress. Oncotarget 2017; 8:82064-82077. [PMID: 29137244 PMCID: PMC5669870 DOI: 10.18632/oncotarget.18289] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 05/06/2017] [Indexed: 01/29/2023] Open
Abstract
It has been reported that microRNAs (miRs) can regulate renal response to acute injury and members of them are believed to be important in maintenance of renal function and development of renal injury. We investigated the actions of microRNA-423-5p (miR-423-5p) and glutathione-S-transferase (GST) M1 after acute kidney injury. MiR-423-5p was up-regulated and GSTM1 was down-regulated in human kidney (HK-2) cells subjected to hypoxia/reoxygenation (H/R) and in rat kidneys subjected to ischemia/reperfusion (I/R) injury. Dual luciferase assays revealed miR-423-5p binding to the 3′ untranslated region of GSTM1. Proliferation was lower and apoptosis, ER stress and oxidative stress were all higher in H/R-treated HK-2 cells transfected with or without miR-423-5p mimics and GSTM1 siRNA than in the same cells transfected with miR-423-5p inhibitors and a GSTM1 expression vector. Increased miR-423-5p and decreased GSTM1 mRNA and protein levels were observed in rat kidneys on days 1, 2 and 7 after I/R. Levels had normalized by days 14 and 21. On day 3 after treatment, rats receiving I/R or I/R plus miR-423-5p mimics exhibited higher serum creatinine and urea nitrogen levels than rats receiving I/R plus a miR-423-5p inhibitor. MiR-423-5p and lower GSTM1 mRNA and protein levels were higher in the I/R and I/R plus miR-423-5p mimic groups than in the I/R plus miR-423-5p inhibitors group. These findings demonstrate that after acute kidney injury, miR-423-5p induces ER stress and oxidative stress by inhibiting GSTM1and suppresses repair.
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Affiliation(s)
- Xiao-Peng Yuan
- 3rd Division of Organ Transplant Center, Eastern Campus of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510700, P.R. China
| | - Long-Shan Liu
- 2nd Division of Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P.R. China
| | - Chuan-Bao Chen
- 3rd Division of Organ Transplant Center, Eastern Campus of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510700, P.R. China
| | - Jian Zhou
- 3rd Division of Organ Transplant Center, Eastern Campus of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510700, P.R. China
| | - Yi-Tao Zheng
- 3rd Division of Organ Transplant Center, Eastern Campus of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510700, P.R. China
| | - Xiao-Ping Wang
- 3rd Division of Organ Transplant Center, Eastern Campus of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510700, P.R. China
| | - Ming Han
- 3rd Division of Organ Transplant Center, Eastern Campus of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510700, P.R. China
| | - Chang-Xi Wang
- 2nd Division of Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P.R. China
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Stone ER, Bruine de Bruin W, Wilkins AM, Boker EM, MacDonald Gibson J. Designing Graphs to Communicate Risks: Understanding How the Choice of Graphical Format Influences Decision Making. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2017; 37:612-628. [PMID: 27862121 DOI: 10.1111/risa.12660] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 03/01/2016] [Accepted: 05/04/2016] [Indexed: 06/06/2023]
Abstract
Previous research suggests that the choice of graphical format for communicating risk information affects both understanding of the risk magnitude and the likelihood of acting to decrease risk. However, the mechanisms through which these effects work are poorly understood. To explore these mechanisms using a real-world scenario, we examined the relative impact of two graphical displays for depicting the risk of exposure to unexploded ammunition during potential land redevelopment. One display depicted only the foreground information graphically (a bar graph of the number of people harmed), and a second depicted the foreground and background graphically (a stacked bar graph representing both the number harmed and at risk). We presented 296 participants with either the foreground-only or the foreground and background graphical display and measured a broad set of outcome variables, examining (1) the graphical display effect on each of the outcome measures and (2) the pathways by which any display effects work to influence decision making. We found that the foreground-only graphical display increased perceived likelihood and experienced fear, which produced greater worry, which in turn increased risk aversion. In addition, a positive evaluation of the communication materials increased support for policies related to land redevelopment, whether those policies were risk taking or risk mitigating. Finally, the foreground-only graphical display decreased understanding of the risk magnitude, showing that approaches to accomplish one risk communication goal (promoting risk-averse decisions) may do so at the expense of another goal (increasing understanding).
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Affiliation(s)
- Eric R Stone
- Department of Psychology, Wake Forest University, Winston-Salem, NC, USA
| | - Wändi Bruine de Bruin
- Centre for Decision Research, Leeds University Business School, Leeds, England
- Department of Engineering and Public Policy, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Abigail M Wilkins
- Department of Psychology, Wake Forest University, Winston-Salem, NC, USA
| | - Emily M Boker
- Department of Psychology, Wake Forest University, Winston-Salem, NC, USA
| | - Jacqueline MacDonald Gibson
- Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Leo MC, McMullen C, Wilfond BS, Lynch FL, Reiss JA, Gilmore MJ, Himes P, Kauffman TL, Davis JV, Jarvik GP, Berg JS, Harding C, Kennedy KA, Simpson DK, Quigley DI, Richards CS, Rope AF, Goddard KAB. Patients' ratings of genetic conditions validate a taxonomy to simplify decisions about preconception carrier screening via genome sequencing. Am J Med Genet A 2016; 170:574-82. [PMID: 26792268 DOI: 10.1002/ajmg.a.37477] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 10/28/2015] [Indexed: 12/27/2022]
Abstract
Advances in genome sequencing and gene discovery have created opportunities to efficiently assess more genetic conditions than ever before. Given the large number of conditions that can be screened, the implementation of expanded carrier screening using genome sequencing will require practical methods of simplifying decisions about the conditions for which patients want to be screened. One method to simplify decision making is to generate a taxonomy based on expert judgment. However, expert perceptions of condition attributes used to classify these conditions may differ from those used by patients. To understand whether expert and patient perceptions differ, we asked women who had received preconception genetic carrier screening in the last 3 years to fill out a survey to rate the attributes (predictability, controllability, visibility, and severity) of several autosomal recessive or X-linked genetic conditions. These conditions were classified into one of five taxonomy categories developed by subject experts (significantly shortened lifespan, serious medical problems, mild medical problems, unpredictable medical outcomes, and adult-onset conditions). A total of 193 women provided 739 usable ratings across 20 conditions. The mean ratings and correlations demonstrated that participants made distinctions across both attributes and categories. Aggregated mean attribute ratings across categories demonstrated logical consistency between the key features of each attribute and category, although participants perceived little difference between the mild and serious categories. This study provides empirical evidence for the validity of our proposed taxonomy, which will simplify patient decisions for results they would like to receive from preconception carrier screening via genome sequencing.
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Affiliation(s)
- Michael C Leo
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Carmit McMullen
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | | | - Frances L Lynch
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Jacob A Reiss
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Marian J Gilmore
- Department of Medical Genetics, Kaiser Permanente Northwest, Portland, Oregon
| | - Patricia Himes
- Department of Medical Genetics, Kaiser Permanente Northwest, Portland, Oregon
| | - Tia L Kauffman
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - James V Davis
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | | | - Jonathan S Berg
- The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Cary Harding
- Department of Molecular and Medical Genetics, Oregon Health & Science University, Portland, Oregon
| | - Kathleen A Kennedy
- Department of Medical Genetics, Kaiser Permanente Northwest, Portland, Oregon
| | | | - Denise I Quigley
- Department of Medical Genetics, Kaiser Permanente Northwest, Portland, Oregon
| | - C Sue Richards
- Department of Molecular and Medical Genetics, Oregon Health & Science University, Portland, Oregon
| | - Alan F Rope
- Department of Medical Genetics, Kaiser Permanente Northwest, Portland, Oregon
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Stone ER, Gabard AR, Groves AE, Lipkus IM. Effects of Numerical Versus Foreground-Only Icon Displays on Understanding of Risk Magnitudes. JOURNAL OF HEALTH COMMUNICATION 2015; 20:1230-1241. [PMID: 26065633 DOI: 10.1080/10810730.2015.1018594] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The aim of this work is to advance knowledge of how to measure gist and verbatim understanding of risk magnitude information and to apply this knowledge to address whether graphics that focus on the number of people affected (the numerator of the risk ratio, i.e., the foreground) are effective displays for increasing (a) understanding of absolute and relative risk magnitudes and (b) risk avoidance. In 2 experiments, the authors examined the effects of a graphical display that used icons to represent the foreground information on measures of understanding (Experiments 1 and 2) and on perceived risk, affect, and risk aversion (Experiment 2). Consistent with prior findings, this foreground-only graphical display increased perceived risk and risk aversion; however, it also led to decreased understanding of absolute (although not relative) risk magnitudes. Methodologically, this work shows the importance of distinguishing understanding of absolute risk from understanding of relative risk magnitudes, and the need to assess gist knowledge of both types of risk. Substantively, this work shows that although using foreground-only graphical displays is an appealing risk communication strategy to increase risk aversion, doing so comes at the cost of decreased understanding of absolute risk magnitudes.
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Affiliation(s)
- Eric R Stone
- a Department of Psychology , Wake Forest University , Winston-Salem , North Carolina , USA
| | - Alexis R Gabard
- a Department of Psychology , Wake Forest University , Winston-Salem , North Carolina , USA
| | - Aislinn E Groves
- a Department of Psychology , Wake Forest University , Winston-Salem , North Carolina , USA
| | - Isaac M Lipkus
- b School of Nursing , Duke University , Durham , North Carolina , USA
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10
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Hay JL, Orom H, Kiviniemi MT, Waters EA. "I don't know" my cancer risk: exploring deficits in cancer knowledge and information-seeking skills to explain an often-overlooked participant response. Med Decis Making 2015; 35:436-45. [PMID: 25810268 DOI: 10.1177/0272989x15572827] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 01/19/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Perceived risk is a central theoretical construct in health behavior research. Participants' "don't know" responses to perceived-risk items (DKPR) are usually excluded from analyses. Yet those who provide such responses may have unique cancer information needs. OBJECTIVE The hypotheses that DKPR responding may be due to cancer knowledge deficits or behavioral, skill, and attitudinal antecedents to knowledge deficits (information seeking, numeracy, and self-efficacy, respectively) were explored. METHODS Data from the 2005 Health Information National Trends Survey (HINTS; N = 1789), a US population-based survey, and an urban, minority, primary care clinic survey (N = 590) were analyzed. Multivariable logistic regressions were conducted to examine knowledge deficit explanations for responding DKPR to colon cancer risk perception questions (adjusting for demographics and family colorectal cancer history). MEASURES Comparative (HINTS) and absolute verbal perceived risk of colon cancer (HINTS, clinic survey), knowledge of colon cancer risks and screening, cancer/health information-seeking behavior and self-efficacy (HINTS), and numeracy (clinic survey). RESULTS Greater knowledge of colon cancer prevention and screening, cancer and health information seeking, and numeracy were each associated with lower odds of providing a DKPR response. LIMITATIONS The study was cross-sectional, which limits the ability to infer causal direction. The use of existing data sets limited our variable choices. Other plausible hypotheses may also explain DKPR responding. CONCLUSIONS People who report that they don't know their colon cancer risk may have low cancer knowledge and reduced knowledge acquisition behaviors and skills. Health behavior research could benefit from including data concerning DKPR responses to risk perception questions, because individuals who respond in this way may require interventions to address potential cancer risk knowledge deficits.
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Affiliation(s)
- Jennifer L Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA (JLH)
| | - Heather Orom
- Department of Community Health & Health Behavior, School of Public Health and Health Professions, University at Buffalo, SUNY, New York, NY, USA (HO, MTK)
| | - Marc T Kiviniemi
- Department of Community Health & Health Behavior, School of Public Health and Health Professions, University at Buffalo, SUNY, New York, NY, USA (HO, MTK)
| | - Erika A Waters
- Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis, St. Louis, MO, USA (EAW)
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Haga SB, Barry WT, Mills R, Svetkey L, Suchindran S, Willard HF, Ginsburg GS. Impact of delivery models on understanding genomic risk for type 2 diabetes. Public Health Genomics 2014; 17:95-104. [PMID: 24577154 DOI: 10.1159/000358413] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 12/19/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Genetic information, typically communicated in-person by genetic counselors, can be challenging to comprehend; delivery of this information online--as is becoming more common--has the potential of increasing these challenges. METHODS To address the impact of the mode of delivery of genomic risk information, 300 individuals were recruited from the general public and randomized to receive genomic risk information for type 2 diabetes mellitus in-person from a board-certified genetic counselor or online through the testing company's website. RESULTS Participants were asked to indicate their genomic risk and overall lifetime risk as reported on their test report as well as to interpret their genomic risk (increased, decreased, or same as population). For each question, 59% of participants correctly indicated their risk. Participants who received their results in-person were more likely than those who reviewed their results on-line to correctly interpret their genomic risk (72 vs. 47%, p = 0.0002) and report their actual genomic risk (69 vs. 49%, p = 0.002). CONCLUSIONS The delivery of personal genomic risk through a trained health professional resulted in significantly higher comprehension. Therefore, if the online delivery of genomic test results is to become more widespread, further evaluation of this method of communication may be needed to ensure the effective presentation of results to promote comprehension.
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Affiliation(s)
- S B Haga
- Duke Institute for Genome Sciences and Policy, Duke University, Durham, N.C., USA
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12
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Sanderson SC, McBride CM, O'Neill SC, Docherty S, Shepperd J, Lipkus IM. Young smokers' interpretations of the estimated lung cancer risk associated with a common genetic variant of low penetrance. Public Health Genomics 2014; 17:68-75. [PMID: 24556984 DOI: 10.1159/000356708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 10/25/2013] [Indexed: 11/19/2022] Open
Affiliation(s)
- S C Sanderson
- Icahn School of Medicine at Mount Sinai, New York, N.Y., USA
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