Jennifer L Hay1, Elizabeth Schofield1, Marc Kiviniemi2, Erika A Waters3, Xuewei Chen4, Kimberly Kaphingst5, Yuelin Li1, Heather Orom4. 1. Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center (MSK), New York, New York, USA. 2. Department of Health, Behavior, and Society, College of Public Health, University of Kentucky, Lexington, KY, USA. 3. Department of Surgery (Division of Public Health Sciences), Washington University Medical School, St. Louis, MO, USA. 4. Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, USA. 5. Department of Communication, University of Utah, Salt Lake City, UT, USA.
Abstract
OBJECTIVE: Many people say they 'don't know' their risk for common diseases (DK responders). Inadequate health literacy and higher disease information avoidance may suppress risk knowledge and thereby increase DK responding. Study goals were to examine two plausible interventions to address the health education needs of DK responders. Design: Participants were identified in a pre-screener as DK responders for either diabetes or colorectal cancer (CRC) risk perception questions (N = 1276; 35% non-white; 49% inadequate health literacy). They were randomly assigned to read either standard or low literacy risk information about diabetes or CRC, and to undergo a self-affirmation intervention or not. Main outcome measure: DK responding following reading the risk information. Results: Neither intervention reduced DK responding. Multivariable analyses showed that health literacy, information avoidance and believing the disease is unpredictable - but not risk factor knowledge and need for cognition - best predicted participants' conversion from a DK response to a non-DK scale point response. Conclusion: Results confirm that both inadequate health literacy and higher information avoidance are associated with DK responding. DK responders are also disproportionately underserved and less adherent to health behaviors. Because galvanising risk perceptions are central to public health, addressing their information needs is a priority.
OBJECTIVE: Many people say they 'don't know' their risk for common diseases (DK responders). Inadequate health literacy and higher disease information avoidance may suppress risk knowledge and thereby increase DK responding. Study goals were to examine two plausible interventions to address the health education needs of DK responders. Design: Participants were identified in a pre-screener as DK responders for either diabetes or colorectal cancer (CRC) risk perception questions (N = 1276; 35% non-white; 49% inadequate health literacy). They were randomly assigned to read either standard or low literacy risk information about diabetes or CRC, and to undergo a self-affirmation intervention or not. Main outcome measure: DK responding following reading the risk information. Results: Neither intervention reduced DK responding. Multivariable analyses showed that health literacy, information avoidance and believing the disease is unpredictable - but not risk factor knowledge and need for cognition - best predicted participants' conversion from a DK response to a non-DK scale point response. Conclusion: Results confirm that both inadequate health literacy and higher information avoidance are associated with DK responding. DK responders are also disproportionately underserved and less adherent to health behaviors. Because galvanising risk perceptions are central to public health, addressing their information needs is a priority.
Entities:
Keywords:
Risk perceptions; health information avoidance; health literacy; uncertainty
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