The Roles of Three Types of Knowledge and Perceived Uncertainty in Explaining Risk Perception, Acceptability, and Self-Protective Response-A Case Study on Endocrine Disrupting Surfactants

Development of a Phthalate Environmental Reproductive Health Literacy (PERHL) Scale

BACKGROUND

Substantial evidence exists linking phthalate exposure to adverse reproductive health outcomes. Current US federal regulations of consumer product chemicals place the onus on individuals to mitigate their exposure to phthalates, with assumptions of sufficient environmental health literacy (EHL). Few validated scales for people of reproductive age exist to evaluate phthalate-specific EHL.

OBJECTIVES

Our objective is to develop a multidimensional scale characterizing latent factors of phthalate knowledge, risk perception, and self-efficacy to inform individual-level interventions for reducing phthalate exposure.

METHODS

We distributed a survey with 31 items to 117 participants in the Environmental Reproductive and Glucose Outcomes (ERGO) cohort who gave birth within the last 5 years. Exploratory factor analysis (EFA) was used to identify underlying latent factors. Internal reliability was assessed via omega hierarchical coefficient. Average sum scores for each latent factor and the overall Phthalate Environmental Reproductive Health Literacy (PERHL) score were calculated. Associations between latent factors, overall PERHL score, and sociodemographic characteristics were explored using linear models.

RESULTS

Six latent factors were identified as follows: "Awareness of Phthalate Reproductive Health Impacts," "Uncertainty," "Protective Behavior/Risk Control," "Regulatory Interest," "Awareness of Phthalate Exposure Pathways," and "General Phthalate Knowledge." Each factor demonstrated acceptable to strong internal reliability, with coefficients ranging between 0.63 and 0.93. Non-white participants had lower scores for the "Awareness of Phthalate Reproductive Health Impacts" [β : - 0.35 , 95% confidence interval (CI): - 0.63 , - 0.07 ], "Awareness of Phthalate Exposure Pathways" (β : - 0.32 , 95% CI: - 0.57 , - 0.07 ), and "General Phthalate Knowledge" (β : - 0.36 , 95% CI: - 0.66 , - 0.06 ), but no significant difference in scores on "Uncertainty" (β : 0.17, 95% CI: - 0.16 , 0.50), "Protective Behavior/Risk Control" (β : - 0.04 , 95% CI: - 0.36 , 0.28), or "Regulatory Interest" (β : - 0.21 , 95% CI: - 0.51 , 0.09). No associations were seen for age or educational attainment and latent or sum factors.

DISCUSSION

Six latent factors were identified for the PERHL scale. Non-white race and ethnicity was associated with lower scores for knowledge-related scale factors. https://doi.org/10.1289/EHP13128.

Bedtime procrastination related to loneliness among Chinese university students during post-pandemic period: a moderated chain mediation model

BACKGROUND

This study examined the relationship between loneliness and bedtime procrastination among Chinese university students, the mediating effects of COVID-19 risk perception and self-regulatory fatigue, and connectedness to nature's protective role, post pandemic.

METHODS

We recruited 855 students to complete the Loneliness, Perceived Risk of COVID-19 Pandemic, Self-Regulatory Fatigue, Bedtime Procrastination, and Connectedness to Nature Scales. Data for descriptive statistics, correlation analysis, and moderated chain mediation effects were analyzed using SPSS 24.0 and process 3.5 macros.

RESULTS

Loneliness positively correlated with bedtime procrastination, COVID-19 risk perception mediated the impact of loneliness on bedtime procrastination, self-regulatory fatigue mediated the effect of loneliness on bedtime procrastination, and COVID-19 risk perception and self-regulatory fatigue mediated the effect between loneliness and bedtime procrastination. Furthermore, connectedness to nature mediated the impact of COVID-19 risk perception on self-regulatory fatigue.

CONCLUSIONS

The results indicate the effects and potential mechanisms of loneliness on bedtime procrastination after the relaxation of the pandemic prevention and control policy in China from the perspective of self-regulatory resources and provide insights into improving university students' sleep routine and mental health post pandemic.

Biocidal products: Opportunities in risk assessment, management, and communication

In the coronavirus disease 2019 era, biocidal products are increasingly used for controlling harmful organisms, including microorganisms. However, assuring safety against adverse health effects is a critical issue from a public health standpoint. This study aimed to provide an overview of key aspects of risk assessment, management, and communication that ensure the safety of biocidal active ingredients and products. The inherent characteristics of biocidal products make them effective against pests and pathogens; however, they also possess potential toxicities. Therefore, public awareness regarding both the beneficial and potential adverse effects of biocidal products needs to be increased. Biocidal active ingredients and products are regulated under specific laws: the Federal Insecticide, Fungicide, and Rodenticide Act for the United States; the European Union (EU) Biocidal Products Regulation for the EU; and the Consumer Chemical Products and Biocide Safety Management Act for the Republic of Korea. Risk management also needs to consider the evidence of enhanced sensitivity to toxicities in individuals with chronic diseases, given the increased prevalence of these conditions in the population. This is particularly important for post-marketing safety assessments of biocidal products. Risk communication conveys information, including potential risks and risk-reduction measures, aimed at managing or controlling health or environmental risks. Taken together, the collaborative effort of stakeholders in risk assessment, management, and communication strategies is critical to ensuring the safety of biocidal products sold in the market as these strategies are constantly evolving.

Behavioral pathways to private well risk mitigation: A structural equation modeling approach

Complex, multihazard risks such as private groundwater contamination necessitate multiannual risk reduction actions including seasonal, weather-based hazard evaluations. In the Republic of Ireland (ROI), high rural reliance on unregulated private wells renders behavior promotion a vital instrument toward safeguarding household health from waterborne infection. However, to date, pathways between behavioral predictors remain unknown while latent constructs such as extreme weather event (EWE) risk perception and self-efficacy (perceived behavioral competency) have yet to be sufficiently explored. Accordingly, a nationwide survey of 560 Irish private well owners was conducted, with structural equation modeling (SEM) employed to identify underlying relationships determining key supply management behaviors. The pathway analysis (SEM) approach was used to model three binary outcomes: information seeking, post-EWE action, and well testing behavior. Upon development of optimal models, perceived self-efficacy emerged as a significant direct and/or indirect driver of all three behavior types-demonstrating the greatest indirect effect (β = -0.057) on adoption of post-EWE actions and greatest direct (β = 0.222) and total effect (β = 0.245) on supply testing. Perceived self-efficacy inversely influenced EWE risk perception in all three models but positively influenced supply awareness (where present). Notably, the presence of a vulnerable (infant and/or elderly) household member negatively influenced adoption of post-EWE actions (β = -0.131, p = 0.016). Results suggest that residential and age-related factors constitute key demographic variables influencing risk mitigation and are strongly mediated by cognitive variables-particularly self-efficacy. Study findings may help contextualize predictors of private water supply management, providing a basis for future risk-based water interventions.

The relationship between information overload and state of anxiety in the period of regular epidemic prevention and control in China: a moderated multiple mediation model

This study aimed to examine the relationship between information overload and individual state anxiety in the period of regular epidemic prevention and control and mediating effect of risk perception and positive coping styles. Further, we explored the moderating role of resilience. 847 Chinese participated in and completed measures of information overload, risk perception, positive coping styles, state anxiety, and resilience. The results of the analysis showed that information overload significantly predicted the level of individual state anxiety (β = 0.27, p < 0.001). Risk perception partially mediate the relationship between information overload and state anxiety (B = 0.08, 95%CI = [0.05, 0.11]) and positive coping styles also partially mediate the relationship between information overload and state anxiety(B = -0.14, 95%CI = [-0.18, -0.10]). In addition, resilience moderated the mediating effects of risk perception (β = -0.07, p < 0.05) and positive coping styles (β = -0.19, p < 0.001). Resilience also moderated the effect of information overload on state anxiety (β = -0.13, p < 0.001). These results offer positive significance for understanding the internal mechanism of the influence of information overload on individual state anxiety in the epidemic environment and shed light on how to reduce people's state anxiety during an epidemic.

Public Awareness and Risk Perceptions of Endocrine Disrupting Chemicals: A Qualitative Study

Endocrine disrupting chemicals (EDCs) are exogenous chemicals found in food, consumer products, and the environment. EDCs are ubiquitous in modern life and exposure is associated with many negative health effects, such as reproductive disorders, metabolic disorders, and cancer. Scientists have deemed EDCs as a serious public health risk, yet the public's perceptions of these chemicals is poorly understood. This study aimed to qualitatively explore how aware the public is of EDCs and their attitudes, beliefs, and perceptions of EDC risk. Thirty-four participants (aged 19-65 years) took part in the six focus groups. Discussions were transcribed verbatim and Nvivo 11 was used for thematic analysis. Our results indicated that awareness of EDCs was low. Themes of EDC risk perception included perceived control, perceived severity, and similarity heuristics. Risk alleviation strategies were also discussed. Future research should use quantitative methodology and a larger sample size to validate the findings from this study. Findings from this study may aid the development of effective risk communication strategies and public health interventions.

Perceptions and Attitudes of Gynecologic and Pediatric Professionals Regarding Dietary Exposure to Chemical Pollutants

There is increasing concern regarding the potential implications of continuous dietary exposure to low doses of artificial chemical pollutants, particularly in critical life stages such as pregnancy and lactation. Within a wider social research, we analyzed the risk perception, discourses, and attitudes of health professionals regarding dietary exposure to artificial chemical contaminants. Data was collected by personal interviews on 35 health professionals from two Spanish regions. Although the participants' discourses were strongly dominated by the nutritional composition and microbiological contamination, 34 expressed some concern regarding metals, and 23 regarding pesticides. Although only one participant mentioned a plasticizer (i.e., bisphenol A), we noted an underlying concern, since six professionals admitted to recommending pregnant women to somewhat avoid plastic food containers, and were aware of mother-to-child transmission and accumulation of artificial chemicals. The ubiquity of the exposure, the inability to locate the threat, and contradictory messages can all create a sense of helplessness and subsequent cognitive adjustments. Our participants also reported a lack of information, particularly on emerging pollutants. In conclusion, we found a range of valuable discourses that can aid in orienting public health strategies aimed at health professionals who have a substantial influence on their patients.

Social Influence, Risk and Benefit Perceptions, and the Acceptability of Risky Energy Technologies: An Explanatory Model of Nuclear Power Versus Shale Gas

Risky energy technologies are often controversial and debates around them are polarized; in such debates public acceptability is key. Research on public acceptability has emphasized the importance of intrapersonal factors but has largely neglected the influence of interpersonal factors. In an online survey (N = 948) with a representative sample of the United Kingdom, we therefore integrate interpersonal factors (i.e., social influence as measured by social networks) with two risky energy technologies that differ in familiarity (nuclear power vs. shale gas) to examine how these factors explain risk and benefit perceptions and public acceptability. Findings show that benefit perceptions are key in explaining acceptability judgments. However, risk perceptions are more important when people are less familiar with the energy technology. Social network factors affect perceived risks and benefits associated with risky energy technology, hereby indirectly helping to form one's acceptability judgment toward the technology. This effect seems to be present regardless of the perceived familiarity with the energy technology. By integrating interpersonal with intrapersonal factors in an explanatory model, we show how the current "risk-benefit acceptability" model used in risk research can be further developed to advance the current understanding of acceptability formation.

The mediating effect of trust on the relationship between doctor-patient communication and patients' risk perception during treatment

Doctor-patient communication interacts with patients' satisfaction to influence patients' risk perception. Current theories to explain this relationship have assumed particular psychological processes to explain observations of risk-sensitive behavior in an economic setting, but as of yet, they have not addressed whether it is adaptive for a decision-maker in a health-care situation. In addition, little is known about the role of interpersonal trust between doctor and patient. We surveyed 602 patients to examine the way in which trust, communication, and patients' satisfaction are related to patients' risk perception about uncertainties in medical treatment. The results showed that patients held a relatively low level of risk perception, which means that they had insufficient preparation for the possibility of uncertainties about the treatment. The association between doctor-patient communication and patients' perceived risk was mediated by doctor-patient trust. These results suggest that there is a relationship among good doctor-patient communication, patients' trust in medical staff, and perceived risk during medical treatment. Finally, theoretical and practical implications are discussed.