Communicating Uncertain Science to the Public: How Amount and Source of Uncertainty Impact Fatalism, Backlash, and Overload

Communicating scientific uncertainty in the early stages of the COVID-19 pandemic: A message experiment

The World Health Organization (WHO) officially declared COVID-19 a pandemic on March 11, 2020. It was a time of significant uncertainty as experts were not yet certain whether social distancing behaviors were necessary to slow the spread of the virus. Some public communicators opted to acknowledge uncertainty based on the limited evidence, whereas others downplayed uncertainty. This situation provided researchers with an opportunity to advance theory by explicating and testing cognitive responses to message uncertainty. Immediately following the WHO declaration (March 13-19, 2020), U.S. adults (N = 1186) were randomly assigned to one of six conditions in a 2 (message uncertainty: low, high) × 3 (argument support: expert, threat, precedent) between-participants experiment. Overall, perceived uncertainty negatively mediated the impact of message uncertainty on intentions. However, participant education was a key moderator. For those with more than a high school education, uncertain messages were related to higher intentions to social distance through increased critical reflection. For those with a high school education or less, uncertain messages were related to lower intentions through decreased message credibility.

Communicating uncertainties regarding COVID-19 vaccination: Moderating roles of trust in science, government, and society

This study examined how uncertainty affects information seeking and avoidance behaviors via information insufficiency in the COVID-19 vaccination context. It also investigated how trust in science, government, and society moderate the effects of information insufficiency. An online experiment with 131 Korean adults showed that uncertainty indirectly affects information seeking intentions via information insufficiency, which is moderated by science trust and governmental trust. It also showed that uncertainty indirectly affects information avoidance intentions via information insufficiency, which is moderated by social trust.

Linking genetic counseling communication skills to patient outcomes and experiences using a community-engagement and provider-engagement approach: research protocol for the GC-PRO mixed methods sequential explanatory study

INTRODUCTION

In over 50 years since the genetic counseling (GC) profession began, a systematic study of GC communication skills and patient-reported outcomes in actual sessions across multiple clinical specialties has never been conducted. To optimize GC quality and improve efficiency of care, the field must first be able to comprehensively measure GC skills and determine which skills are most critical to achieving positive patient experiences and outcomes. This study aims to characterise GC communication skills using a novel and pragmatic measure and link variations in communication skills to patient-reported outcomes, across clinical specialties and with patients from diverse backgrounds in the USA. Our community-engagement and provider-engagement approach is crucial to develop recommendations for quality, culturally informed GC care, which are greatly needed to improve GC practice.

METHODS AND ANALYSIS

A mixed methods, sequential explanatory design will be used to collect and analyze: audio-recorded GC sessions in cancer, cardiac, and prenatal/reproductive genetic indications; pre-visit and post-visit quantitative surveys capturing patient experiences and outcomes and post-visit qualitative interview data. A novel, practical checklist will measure GC communication skills. Coincidence analysis will identify patterns of GC skills that are consistent with high scores on patient-reported measures. Two-level, multilevel models will be used to evaluate how GC communication skills and other session/patient characteristics predict patient-reported outcomes. Four community advisory boards (CABs) and a genetic counselor advisory board will inform the study design and analysis.

ETHICS AND DISSEMINATION

This study has been approved by the single Institutional Review Board of the University of Minnesota. This research poses no greater than minimal risk to participants. Results from this study will be shared through national and international conferences and through community-based dissemination as guided by the study's CABs. A lay summary will also be disseminated to all participants.

Framing COVID-19 Preprint Research as Uncertain: A Mixed-Method Study of Public Reactions

During the COVID-19 pandemic, journalists were encouraged to convey uncertainty surrounding preliminary scientific evidence, including mentioning when research is unpublished or unverified by peer review. To understand how public audiences interpret this information, we conducted a mixed method study with U.S. adults. Participants read a news article about preprint COVID-19 vaccine research in early April 2021, just as the vaccine was becoming widely available to the U.S. public. We modified the article to test two ways of conveying uncertainty (hedging of scientific claims and mention of preprint status) in a 2 × 2 between-participants factorial design. To complement this, we collected open-ended data to assess participants' understanding of the concept of a scientific preprint. In all, participants who read hedged (vs. unhedged) versions of the article reported less favorable vaccine attitudes and intentions and found the scientists and news reporting less trustworthy. These effects were moderated by participants' epistemic beliefs and their preference for information about scientific uncertainty. However, there was no impact of describing the study as a preprint, and participants' qualitative responses indicated a limited understanding of the concept. We discuss implications of these findings for communicating initial scientific evidence to the public and we outline important next steps for research and theory-building.

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.

[Should we take into account the informational stress of the medical oncologist?]

Information overload, informational stress and its deleterious consequences constitute a subject of growing interest in the way of work. This is quite well documented among anesthesiologists. Studies have also been carried out on cancer patients or on the general public in terms of cancer prevention. After having defined the concepts and the consequences, we hypothesize the presence of informational stress among medical oncologists. We illustrate this hypothesis regarding adjuvant treatment of breast cancer. Specific studies (qualitative and quantitative ones) would be particularly interesting in oncology.

Why did people avoid information during the COVID-19 pandemic? Understanding information sources' dynamics among Pakistani Z generation

Purpose

Grounded in the stressor-strain-outcome model, this study aims to examine the impact of different information sources on information behavior among the Pakistani Z generation during the pandemic.

Design/methodology/approach

The study was quantitative, with 344 responses collected from Gen Z (those born in the late 1990s) using an online survey. The proposed structural model was tested with the help of SmartPLS 3.3. Information sources were divided into four categories, i.e. conventional media, personal networks, social media and Internet use through official health websites.

Findings

In the Pakistani context, conventional media was found to develop information overload among Zers, whereas social media and personal networks were positively associated with information anxiety. However, Internet use (official and medical websites) for health-related information-seeking significantly reduced information anxiety among people. None of these information sources are the reason for information avoidance but the sources affect either the independent predictor of information avoidance or the mediators. Whereas information overload is a predictor of information anxiety and information, anxiety is a mediator between information overload and avoidance behavior.

Research limitations/implications

To avoid the negative consequences of abundant information, the authors need to promote and encourage the use of authentic information sources to make Gen Z skeptical, independent, critical and scientific thinkers.

Originality/value

Information sources' dynamics in terms of negative consequences of abundant information has not been explored previously at this magnitude, particularly from the perspective of a developing country.

Trust and consequences: Role of community science, perceptions, values, and environmental justice in risk communication

Risk communication is often viewed as imparting information and perhaps as a two-way dialogue. Risk communication inadequacies on the part of both "communicator" and "community members" can lead to adverse consequences and amplify environmental justice disparities. The paper suggests a transformational approach where risk communicators must learn to trust community experts and their knowledge base (and act upon it), where risk information imparted by risk communicators addresses what communities are most concerned about (as well as risk from specific chemicals or radionuclides), and where risk information and assessments address underlying issues and disparities, as well as cultural traditions (among others). Providing risk probabilities is no longer sufficient; western science may not be enough, and community and native scientific knowledge is needed. Risk communication (or information transfer) for environmental risks that are ongoing usually applies to low-income, minority communities-people living in dense inner cities, rural communities, Native American communities-or to people living near a risky facility. Communication within this context requires mutual trust, listening and respect, as well as acceptance of indigenous and community knowledge as equally valuable. Examples are given to illustrate a community perspective.

Public engagement and argumentation in science

Public engagement is one of the fundamental pillars of the European programme for research and innovation Horizon 2020. The programme encourages engagement that not only fosters science education and dissemination, but also promotes two-way dialogues between scientists and the public at various stages of research. Establishing such dialogues between different groups of societal actors is seen as crucial in order to attain epistemic as well as social desiderata at the intersection between science and society. However, whether these dialogues can actually help attaining these desiderata is far from obvious. This paper discusses some of the costs, risks, and benefits of dialogical public engagement practices, and proposes a strategy to analyse these argumentative practices based on a three-tiered model of epistemic exchange. As a case study, we discuss the phenomenon of vaccine hesitancy, arguably a result of suboptimal public engagement, and show how the proposed model can shed new light on the problem.

Examining Rural-Urban Differences in Fatalism and Information Overload: Data from 12 NCI-Designated Cancer Centers

BACKGROUND

Rural populations experience a disproportionate cancer burden relative to urban populations. One possibility is that rural populations are more likely to hold counterproductive cancer beliefs such as fatalism and information overload that undermine prevention and screening behaviors.

METHODS

Between 2016 and 2020, 12 U.S. cancer centers surveyed adults in their service areas using online and in-person survey instruments. Participants (N = 10,362) were designated as rural (n = 3,821) or urban (n = 6,541). All participants were 18 and older (M = 56.97, SD = 16.55), predominately non-Hispanic White (81%), and female (57%). Participants completed three items measuring cancer fatalism ("It seems like everything causes cancer," "There's not much you can do to lower your chances of getting cancer," and "When I think about cancer, I automatically think about death") and one item measuring cancer information overload ("There are so many different recommendations about preventing cancer, it's hard to know which ones to follow").

RESULTS

Compared with urban residents, rural residents were more likely to believe that (i) everything causes cancer (OR = 1.29; 95% CI, 1.17-1.43); (ii) prevention is not possible (OR = 1.34; 95% CI, 1.19-1.51); and (iii) there are too many different recommendations about cancer prevention (OR = 1.26; 95% CI, 1.13-1.41), and cancer is always fatal (OR = 1.21; 95% CI, 1.11-1.33).

CONCLUSIONS

Compared with their urban counterparts, rural populations exhibited higher levels of cancer fatalism and cancer information overload.

IMPACT

Future interventions targeting rural populations should account for higher levels of fatalism and information overload.

The explanation of a complex problem: A content analysis of causality in cancer news

Understanding causality is a critical part of developing preventive and treatment actions against cancer. Three main causality models-necessary, sufficient-component, and probabilistic causality have been commonly used to explain the causation between causal factors and risks in health science. However, news media do not usually follow a strict protocol to report the causality of health risks. The purpose of this study was to describe and understand how the causation of cancer was articulated on news media. A content analysis of 471 newspaper articles published in the United States during two time-frames (2007-2008 and 2017-2018) was conducted. The analysis showed that probabilistic causality was most frequently used to explain the causal relationship between risk factors and cancer. The findings also uncovered other important details of news framing, including types and characteristics of risk factors, intervention measures, and sources of evidence. The results provided theoretical and practical implications for public understanding and assessment of cancer risks.

Psychological Impact of Ambiguous Health Messages about COVID-19

Perceiving ambiguity in health information-that is, uncertainty elicited from believing information lacks credibility, reliability, or adequacy-is typically associated with pessimistic appraisals (e.g., high perceived disease risk) and behavioral avoidance. We examined the effect of ambiguous health information about COVID-19 on health cognitions and vaccination intentions, and tested a "normalized-uncertainty" intervention. Two studies with identical methodology (online adult sample: n = 299, undergraduate sample: n = 150) were conducted in March to April 2020. Participants were randomly assigned to read one of three health messages about COVID-19 that emphasized what was currently unknown (ambiguity condition), what was currently unknown but that scientific uncertainty is expected (intervention condition), or what was currently known (control condition). The ambiguity condition led to greater perceived ambiguity than the control condition and perceived ambiguity in the intervention condition was comparable to the ambiguity condition. There were few differences in health cognitions, and no differences in vaccination intentions, when examining pairwise comparisons across the three conditions. Correlational analyses collapsing across condition indicated evidence of pessimistic appraisal but not behavioral avoidance among individuals who perceived greater ambiguity. Future research should examine longer, more detailed normalized-uncertainty interventions.

Communication of Uncertainty about Preliminary Evidence and the Spread of Its Inferred Misinformation during the COVID-19 Pandemic-A Weibo Case Study

The rapid spread of preliminary scientific evidence is raising concerns on its role in producing misinformation during the COVID-19 pandemic. This research investigated how the communication of uncertainty about preliminary evidence affects the spread of its inferred misinformation in a Weibo case study. In total, 3439 Weibo posts and 10,380 reposts regarding the misinformation of pets transmitting COVID-19 were analyzed. The results showed that attitude ambiguity toward the preliminary evidence and the stage when the evidence was first released with uncertainty were associated with higher numbers of likes and retweets of misinformation posts. Our study highlights the internal sources of misinformation and revisits the contextual perspective in misinformation studies.

Effects of communicating uncertainty descriptions in hazard identification, risk characterization, and risk protection

Uncertainty is a crucial issue for any risk assessment. Consequently, it also poses crucial challenges for risk communications. Many guidebooks advise reporting uncertainties in risk assessments, expecting that the audience will appreciate this disclosure. However, the empirical evidence about the effects of uncertainty reporting is sparse and inconclusive. Therefore, based on examples of potential health risks of electromagnetic fields (EMF), three experiments were conducted analysing the effects of communicating uncertainties separately for hazard identification, risk characterisation and risk protection. The setups aimed to explore how reporting and how explaining of uncertainty affects dependent variables such as risk perception, perceived competence of the risk assessors, and trust in risk management. Each of the three experiments used a 2x2 design with a first factor presenting uncertainty descriptions (as used in public controversies on EMF related health effects) or describing a certainty conditions; and a second factor explaining the causes of uncertainties (by pointing at knowledge gaps) or not explaining them. The study results indicate that qualitative uncertainty descriptions regarding hazard identification reduce the confidence in the professional competencies of the assessors. In contrast, a quantitative uncertainty description in risk characterisation-regarding the magnitude of the risk-does not affect any of the dependent variables. Concerning risk protection, trust in exposure limit values is not affected by qualitative uncertainty information. However, the qualitative description of uncertainty regarding the adequacy of protection amplifies fears. Furthermore, explaining this uncertainty results in lower text understandability.

Feel Worried, Overloaded, or Fatalistic? The Determinants of Cancer Uncertainty Management Preferences

Uncertainty in the context of cancer involves a complex and conflicting decision-making process. Individual preferences of seeking or avoiding information in the decisions of maintaining, reducing, or increasing uncertainty often depend on key cancer-related beliefs. The present study investigates whether cancer worry (CW), information overload (CIO), or fatalism (CF) can predict four constructs of uncertainty management preferences - avoid to maintain hope, avoid insufficient information, seek to increase uncertainty, and seek to reduce uncertainty. A hybrid model with structural and measurement components was specified and tested. The model analysis shows that cancer-related beliefs influenced individuals' needs and preferences for uncertainty management through seeking or avoiding information. CW was positively related to all but avoiding insufficient information. CIO was positively associated with all four preferences. CF was only associated with avoiding to maintain uncertainty. Theoretical and practical implications were discussed.

From information seeking to information avoidance: Understanding the health information behavior during a global health crisis

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The study examines the factors leading to information avoidance during COVID-19 pandemic.

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Mass Media, Print Media and official websites are used for information seeking during the pandemic.

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Only Social Media exposure results in information overload and information anxiety.

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Information overload is strongly associated with information anxiety which gives rise to information avoidance.

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We extend the applicability of S-O-R model to the information behavior domain, especially during the uncertain times.

Individuals seek information for informed decision-making, and they consult a variety of information sources nowadays. However, studies show that information from multiple sources can lead to information overload, which then creates negative psychological and behavioral responses. Drawing on the Stimulus-Organism-Response (S-O-R) framework, we propose a model to understand the effect of information seeking, information sources, and information overload (Stimuli) on information anxiety (psychological organism), and consequent behavioral response, information avoidance during the global health crisis (COVID-19). The proposed model was tested using partial least square structural equation modeling (PLS-SEM) for which data were collected from 321 Finnish adults using an online survey. People found to seek information from traditional sources such as mass media, print media, and online sources such as official websites and websites of newspapers and forums. Social media and personal networks were not the preferred sources. On the other hand, among different information sources, social media exposure has a significant relationship with information overload as well as information anxiety. Besides, information overload also predicted information anxiety, which further resulted in information avoidance.

Risk Analysis: Celebrating the Accomplishments and Embracing Ongoing Challenges

As part of the celebration of the 40th anniversary of the Society for Risk Analysis and Risk Analysis: An International Journal, this essay reviews the 10 most important accomplishments of risk analysis from 1980 to 2010, outlines major accomplishments in three major categories from 2011 to 2019, discusses how editors circulate authors' accomplishments, and proposes 10 major risk-related challenges for 2020-2030. Authors conclude that the next decade will severely test the field of risk analysis.

The Evolving Field of Risk Communication

The 40th Anniversary of the Society for Risk Analysis presents an apt time to step back and review the field of risk communication. In this review, we first evaluate recent debates over the field's current state and future directions. Our takeaway is that efforts to settle on a single, generic version of what constitutes risk communication will be less productive than an open-minded exploration of the multiple forms that comprise today's vibrant interdisciplinary field. We then review a selection of prominent cognitive, cultural, and social risk communication scholarship appearing in the published literature since 2010. Studies on trust in risk communication messengers continued to figure prominently, while new research directions emerged on the opportunities and critical challenges of enhancing transparency and using social media. Research on message attributes explored how conceptual insights particularly relating to framing, affective and emotional responses, and uncertainty might be operationalized to improve message effectiveness. Studies consistently demonstrated the importance of evaluation and how varying single attributes alone is unlikely to achieve desired results. Research on risk communication audiences advanced on risk perception and multiway engagement with notable interest in personal factors such as gender, race, age, and political orientation. We conclude by arguing that the field's interdisciplinary tradition should be further nurtured to drive the next evolutionary phase of risk communication research.

A review of the effects of uncertainty in public science communication

Uncertainty is inherent to science and science communication. However, the evidence appears mixed regarding whether portraying uncertainty in science communication has positive or negative effects. We review a diverse range of experimental literature (k = 48; from 40 searches and 8000 retrievals), summarize the extant findings, and observe how the effects vary across four different types of communicated uncertainty (deficient, technical, scientific, and consensus uncertainty). The results indicate that most findings of negative effects (such as reduced credibility and beliefs) are from experiments that operationalized uncertainty as disagreement or conflict in science (consensus uncertainty). In this review, consensus uncertainty was never found to have positive effects. In contrast, uncertainty in the form of quantified error ranges and probabilities (technical uncertainty) in these studies has had only positive or null effects, not negative effects. We also highlight frequent moderators of the effects of uncertainty, such as prior beliefs and worldviews.

Revisiting nutrition backlash: Psychometric properties and discriminant validity of the nutrition backlash scale

OBJECTIVES

Nutrition backlash is a disposition defined by negative feelings about dietary recommendations. Past research has measured nutrition backlash using the nutrition backlash scale (NBS) and found that it is negatively related to the consumption of fruits and vegetables. The aim of this study was to examine several aspects of the NBS, including factor structure, discriminant validity, and relationship to demographic characteristics and health behaviors.

METHODS

Adults were recruited to participate in two studies. Study 1 (N = 480) included measures of nutritional backlash, information overload, worry, fatalism, and nutrition-related behaviors. Study 2 (N = 399) was a follow-up that examined the factor structure of the NBS in a separate sample.

RESULTS

In study 1, a six-item version of the NBS was found to be a good fit for the data and discriminant from overload, worry, and fatalism. NBS was higher for those with less education, non-white participants, and men. Individuals with higher backlash were less likely to look at nutritional labels and to use sunscreen. Study 2 confirmed the factor structure from study 1.

CONCLUSIONS

A six-item version of the NBS was found to be reliable, discriminant from related measures, higher in underserved groups (less-educated, non-white, and male participants), and related to nutrition label use.

Tracing the evolution of AI: conceptualization of artificial intelligence in mass media discourse

Purpose

This study/paper aims to understand the public perceptions of AI through mass media discourse. In the past few years, significant progress has been made in the field of artificial intelligence (AI). The benefits of AI are obvious, but there is still huge uncertainty and controversy over the public perception of AI. How does the mass media conceptualize AI?

Design/methodology/approach

In this paper, the authors analyze the evolution of AI covered by five major news media outlets in the past 30 years from 7 dimensions: scientific subject, keyword, country, institution, people, topic and opinion polarity.

Findings

First of all, different subjects are competing for and dividing up the right to speak of AI, leading to the gradual fragmentation of the concept of AI. Second, reporting on AI often includes reference to commercial institutions and scientists, showing a successful integration of science and business. Moreover, the result of topic modeling shows that news media mainly defines AI from three perspectives: an imagination, a commercial product and a field of scientific research. Finally, negative reports have focused on various issues relating to AI ethics.

Originality/value

The results can help bridge various conversations surrounding AI and promote richer discussions, increase the participation of scientists, businesses, governments and the public and provide more perspectives on the functions, prospects and pitfalls of AI.

Crafting effective messages to enhance safe infant sleep

BACKGROUND

Health care professionals are continually challenged by the need to provide health information in a way that successfully changes health practices. Research has documented this as a concern in relation to safe infant sleep health campaigns. Often, caregivers' knowledge of recommended practices is not associated with a change in infant sleep choices.

PURPOSE

Health campaigns, including most safe infant sleep efforts, often share specific risk factors and steps for avoiding risk, that is, in a verbatim format. Research has shown that caregivers' behavior may be more likely to change when presented with messages based on their general understanding of risk, that is, gist-based format. This research examines caregivers' responses as related to verbatim- and gist-based safe sleep information.

METHODS

Five hundred forty-one caregivers of infants were shown 12 images depicting infants in safe or unsafe sleep spaces. Images varied across three commercially available spaces, infant race, and presence/absence of one policy-based risk factor.

RESULTS

Differences in caregivers' discernment of safe and unsafe sleep images paralleled reported differences in knowledge of safe sleep recommendations. Discernment of safe/unsafe images was greater for White than Black caregivers, as well as for females in comparison with male caregivers. Gist-based considerations, such as familiarity with the sleeper depicted or infant race, were also associated with caregivers' discernment of safe/unsafe images.

IMPLICATIONS FOR PRACTICE

Attending to both gist- and verbatim-based knowledge regarding safe infant sleep campaign information may help to effectively facilitate caregivers' ability to always create safe sleep spaces for their infants.

Health information overload among health consumers: A scoping review

OBJECTIVE

To examine and identify the scope of research addressing health information overload in consumers.

METHODS

In accordance with a published protocol, six electronic databases (PubMed, CINAHL, ERIC, PsycINFO, Embase, and Scopus), reference lists of included articles, and grey literature (Google Advanced Search and WorldCat) were searched. Articles in English were included, without any limit on the date of publication.

RESULTS

Of the 69 records included for final analysis, 22 studies specifically examined health information overload, whereas the remainder peripherally discussed the concept alongside other concepts. The 22 studies focused on one or more of the following: 1) ways to measure health information overload (multi-item/single-item scales); 2) predictors of health information overload - these included low education level, health literacy, and socioeconomic status; and 3) interventions to address information overload, such as videotaped consultations or written materials. Cancer information overload was a popular topic amongst studies that focused on information overload.

CONCLUSION

Based on the identified studies, there is a clear need for future studies that investigate health information overload in consumers with chronic medical conditions other than cancer.

PRACTICE IMPLICATIONS

This review is the initial step in facilitating future efforts to create health information that do not overload consumers.

The impact of cancer information online on cancer fatalism: education and eHealth literacy as moderators

One critical yet understudied concept associated with cancer information is cancer fatalism, i.e. deterministic thoughts about the cause of cancer, the inability to prevent it and the unavoidability of death upon diagnosis. The aim of this study is to understand how information seeking about cancer online influences cancer fatalism and whether and to what extent education and eHealth literacy moderate the relationship between them. Findings from an online survey of a nationally representative sample in the United States (N = 578) showed differential impacts of using the internet to search for information about cancer among the more and the less educated. For the less educated, more exposure to information about cancer via medical and health websites led to an increased level of cancer fatalism, whereas among the more educated, greater exposure lowered cancer fatalism. These differences were explained by the fact that the more educated were equipped with a higher level of eHealth literacy skills than the less educated. Findings show that only when one has necessary skills to apply digital resources can those resources help mitigate cancer fatalism. We suggest the need to enhance eHealth literacy skills among the less educated to reduce cancer fatalism.

Communicating uncertainty about facts, numbers and science

Uncertainty is an inherent part of knowledge, and yet in an era of contested expertise, many shy away from openly communicating their uncertainty about what they know, fearful of their audience's reaction. But what effect does communication of such epistemic uncertainty have? Empirical research is widely scattered across many disciplines. This interdisciplinary review structures and summarizes current practice and research across domains, combining a statistical and psychological perspective. This informs a framework for uncertainty communication in which we identify three objects of uncertainty-facts, numbers and science-and two levels of uncertainty: direct and indirect. An examination of current practices provides a scale of nine expressions of direct uncertainty. We discuss attempts to codify indirect uncertainty in terms of quality of the underlying evidence. We review the limited literature about the effects of communicating epistemic uncertainty on cognition, affect, trust and decision-making. While there is some evidence that communicating epistemic uncertainty does not necessarily affect audiences negatively, impact can vary between individuals and communication formats. Case studies in economic statistics and climate change illustrate our framework in action. We conclude with advice to guide both communicators and future researchers in this important but so far rather neglected field.

Television News Coverage of Public Health Issues and Implications for Public Health Policy and Practice

Television (TV) news, and especially local TV news, remains an important vehicle through which Americans obtain information about health-related topics. In this review, we synthesize theory and evidence on four main functions of TV news in shaping public health policy and practice: reporting events and information to the public (surveillance); providing the context for and meaning surrounding health issues (interpretation); cultivating community values, beliefs, and norms (socialization); and attracting and maintaining public attention for advertisers (attention merchant). We also identify challenges for TV news as a vehicle for improving public health, including declining audiences, industry changes such as station consolidation, increasingly politicized content, potential spread of misinformation, and lack of attention to inequity. We offer recommendations for public health practitioners and researchers to leverage TV news to improve public health and advance health equity.

Guidance on Communication of Uncertainty in Scientific Assessments

This document provides guidance for communicators on how to communicate the various expressions of uncertainty described in EFSA's document: 'Guidance on uncertainty analysis in scientific assessments'. It also contains specific guidance for assessors on how best to report the various expressions of uncertainty. The document provides a template for identifying expressions of uncertainty in scientific assessments and locating the specific guidance for each expression. The guidance is structured according to EFSA's three broadly defined categories of target audience: 'entry', 'informed' and 'technical' levels. Communicators should use the guidance for entry and informed audiences, while assessors should use the guidance for the technical level. The guidance was formulated using evidence from the scientific literature, grey literature and two EFSA research studies, or based on judgement and reasoning where evidence was incomplete or missing. The limitations of the evidence sources inform the recommendations for further research on uncertainty communication.

Assessing the impact of the public nutrition information environment: Adapting the cancer information overload scale to measure diet information overload

OBJECTIVE

A growing body of research suggests that exposure to too much information - particularly contradictory information that characterizes much health-related information - can lead to feeling overwhelmed. This construct has been conflated with fatalistic beliefs that are negatively associated with preventive behaviors. The objective of this study was to adapt the 8-item Cancer Information Overload (CIO) scale to assess overload of healthy diet information.

METHODS

Confirmatory factor analyses with a community sample of rural California adults (n = 290; 75% female; 58% Latino; 46% ≤ H.S./G.E.D.).

RESULTS

Items assessing Diet Information Overload loaded significantly on their relevant factor; factor loadings were acceptable (β >.40). The adapted original scale (CFI = 1.000, RSMEA = .000, SMSR = .022) and a shorter 5-item scale (CFI = .984, RMSEA = .051, SMSR = .026) fit well.

CONCLUSION

The Cancer Information Overload scale was successfully adapted and shortened to measure perceptions - previously mischaracterized as fatalistic - pertaining to diet information. Improved measures distinguishing between fatalistic beliefs and outcomes of the information environment are critical.

PRACTICE IMPLICATIONS

Understanding information overload is important for shaping prevention messages distinct from those needed to address fatalistic beliefs. Nutrition education efforts should consider the broader - cluttered - information environment in which nutrition education and communication occurs, and public health messages may drown.

Effects of Acknowledging Uncertainty about Earthquake Risk Estimates on San Francisco Bay Area Residents' Beliefs, Attitudes, and Intentions

We test here the risk communication proposition that explicit expert acknowledgment of uncertainty in risk estimates can enhance trust and other reactions. We manipulated such a scientific uncertainty message, accompanied by probabilities (20%, 70%, implicit ["will occur"] 100%) and time periods (10 or 30 years) in major (≥magnitude 8) earthquake risk estimates to test potential effects on residents potentially affected by seismic activity on the San Andreas fault in the San Francisco Bay Area (n = 750). The uncertainty acknowledgment increased belief that these specific experts were more honest and open, and led to statistically (but not substantively) significant increases in trust in seismic experts generally only for the 20% probability (vs. certainty) and shorter versus longer time period. The acknowledgment did not change judged risk, preparedness intentions, or mitigation policy support. Probability effects independent of the explicit admission of expert uncertainty were also insignificant except for judged risk, which rose or fell slightly depending upon the measure of judged risk used. Overall, both qualitative expressions of uncertainty and quantitative probabilities had limited effects on public reaction. These results imply that both theoretical arguments for positive effects, and practitioners' potential concerns for negative effects, of uncertainty expression may have been overblown. There may be good reasons to still acknowledge experts' uncertainties, but those merit separate justification and their own empirical tests.