Grant Number:	1R01CA197351-01 Interpret this number
Primary Investigator:	Orom, Heather
Organization:	State University Of New York At Buffalo
Project Title:	"Don't Know" Responses to Risk Perception Questions: Identifying Mechanisms and Solutions
Fiscal Year:	2015

¿ DESCRIPTION (provided by applicant): Strategies to change risk perceptions are a models of health decision making. Both are based on an assumption that may not always be true - that individuals know their risk for a given illness. Preliminary work from our and other laboratories has shown that a non-trivial portion of the population is uncertain about their risk for common illnesses. Moreover, we have shown that uncertainty about one's illness risk is particularly likely among U.S. populations who suffer the burden of health disparities. However, the mechanisms underlying risk uncertainty remain unknown, which limits our ability to develop effective intervention strategies to change behavior, especially in those who remain uncertain about their risk despite the wide-spread dissemination of risk-based health messaging. The objective for this R01 program of research is to explicate the mechanisms leading individuals to answer "do not know" in response to risk perception questions. In a program of research encompassing both observational and experimental work, we will examine how factors relating to knowledge and health literacy as well as factors related to defensive information avoidance influence do not know responding. This objective will be achieved by addressing two specific aims: 1) To explore two distinct, theoretically-informed explanations for do not know responding, and 2) To test whether experimentally manipulating the mechanisms hypothesized to cause do not know responding, reduces do not know responding. Aim 1 will be achieved with a national survey examining if low health literacy and defensive risk information avoidance are related to do not know responding to colorectal cancer and type 2 diabetes risk perception items. Achieving Aim 2 will be accomplished by experimentally testing 1) whether giving do not know responders with low health literacy health messages tailored to a low health literacy audience increases risk knowledge and reduces do not know responding and 2) whether giving do not know responders who tend to avoid health information the opportunity to self-affirm prior to receiving health messages increases attending to, and comprehension of these messages and reduces do not know responding. This research is significant in that it examines a key, but understudied phenomenon related to a central decision making and behavior change construct, uncertainty about perceived risk for illness. Successful completion of the proposed research will generate tested strategies for developing more effective behavior change messages for individuals who are uncertain about their risk for common illnesses. Given the degree to which uncertainty about illness risk is more common in groups experiencing health disparities populations, our work has the potential to address behavior change factors that contribute to these ongoing health disparities.




Dismissing "Don't Know" Responses to Perceived Risk Survey Items Threatens the Validity of Theoretical and Empirical Behavior-Change Research.
Authors: Waters E.A. , Kiviniemi M.T. , Hay J.L. , Orom H. .
Source: Perspectives On Psychological Science : A Journal Of The Association For Psychological Science, 2021-11-23 00:00:00.0; , p. 17456916211017860.
EPub date: 2021-11-23 00:00:00.0.
PMID: 34813719
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Examining strategies for addressing high levels of 'I don't know' responding to risk perception questions for colorectal cancer and diabetes: an experimental investigation.
Authors: Hay J.L. , Schofield E. , Kiviniemi M. , Waters E.A. , Chen X. , Kaphingst K. , Li Y. , Orom H. .
Source: Psychology & Health, 2020-09-02 00:00:00.0; , p. 1-17.
EPub date: 2020-09-02 00:00:00.0.
PMID: 32876479
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Cultural Worldviews and Perceived Risk of Colon Cancer and Diabetes.
Authors: Chen X. , Orom H. , Kiviniemi M.T. , Waters E.A. , Schofield E. , Li Y. , Hay J.L. .
Source: Health, Risk & Society, 2020; 22(5-6), p. 324-345.
EPub date: 2020-09-29 00:00:00.0.
PMID: 33762881
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Using NCI-Designated Cancer Center Catchment-Area Data to Understand an Ignored but High-Need Constituent: People Uncertain or Avoidant about Their Cancer Risk.
Authors: Hay J.L. , Kiviniemi M.T. , Orom H. , Waters E.A. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2019 Dec; 28(12), p. 1955-1957.
EPub date: 2019-09-09 00:00:00.0.
PMID: 31501151
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Lay beliefs about risk: relation to risk behaviors and to probabilistic risk perceptions.
Authors: Riley K.E. , Hay J.L. , Waters E.A. , Biddle C. , Schofield E. , Li Y. , Orom H. , Kiviniemi M.T. .
Source: Journal Of Behavioral Medicine, 2019-05-15 00:00:00.0; , .
EPub date: 2019-05-15 00:00:00.0.
PMID: 31093806
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Differences in Rural and Urban Health Information Access and Use.
Authors: Chen X. , Orom H. , Hay J.L. , Waters E.A. , Schofield E. , Li Y. , Kiviniemi M.T. .
Source: The Journal Of Rural Health : Official Journal Of The American Rural Health Association And The National Rural Health Care Association, 2018-11-16 00:00:00.0; , .
EPub date: 2018-11-16 00:00:00.0.
PMID: 30444935
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Examining the Interrelations Among Objective and Subjective Health Literacy and Numeracy and Their Associations with Health Knowledge.
Authors: Waters E.A. , Biddle C. , Kaphingst K.A. , Schofield E. , Kiviniemi M.T. , Orom H. , Li Y. , Hay J.L. .
Source: Journal Of General Internal Medicine, 2018 11; 33(11), p. 1945-1953.
EPub date: 2018-08-17 00:00:00.0.
PMID: 30120636
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Low Health Literacy and Health Information Avoidance but Not Satisficing Help Explain "Don't Know" Responses to Questions Assessing Perceived Risk.
Authors: Orom H. , Schofield E. , Kiviniemi M.T. , Waters E.A. , Biddle C. , Chen X. , Li Y. , Kaphingst K.A. , Hay J.L. .
Source: Medical Decision Making : An International Journal Of The Society For Medical Decision Making, 2018 Nov; 38(8), p. 1006-1017.
PMID: 30403579
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Education-based disparities in knowledge of novel health risks: The case of knowledge gaps in HIV risk perceptions.
Authors: Kiviniemi M.T. , Orom H. , Waters E.A. , McKillip M. , Hay J.L. .
Source: British Journal Of Health Psychology, 2018 May; 23(2), p. 420-435.
EPub date: 2018-01-31 00:00:00.0.
PMID: 29388364
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Differences in Access to and Use of Electronic Personal Health Information Between Rural and Urban Residents in the United States.
Authors: Greenberg A.J. , Haney D. , Blake K.D. , Moser R.P. , Hesse B.W. .
Source: The Journal Of Rural Health : Official Journal Of The American Rural Health Association And The National Rural Health Care Association, 2018 Feb; 34 Suppl 1, p. s30-s38.
EPub date: 2017-01-11 00:00:00.0.
PMID: 28075508
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Health Literacy and Use and Trust in Health Information.
Authors: Chen X. , Hay J.L. , Waters E.A. , Kiviniemi M.T. , Biddle C. , Schofield E. , Li Y. , Kaphingst K. , Orom H. .
Source: Journal Of Health Communication, 2018; 23(8), p. 724-734.
EPub date: 2018-08-30 00:00:00.0.
PMID: 30160641
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Causes and consequences of uncertainty about illness risk perceptions.
Authors: Orom H. , Biddle C. , Waters E.A. , Kiviniemi M.T. , Sosnowski A.N. , Hay J.L. .
Source: Journal Of Health Psychology, 2017-12-01 00:00:00.0; , p. 1359105317745966.
EPub date: 2017-12-01 00:00:00.0.
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Tanning and Teens: Is Indoor Exposure the Tip of the Iceberg?
Authors: Hay J.L. , Riley K.E. , Geller A.C. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2017 Aug; 26(8), p. 1170-1174.
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Source: Bioconjugate Chemistry, 2010-05-19 00:00:00.0; 21(5), p. 884-91.
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