Risk communication and public participation during the investigation of cancer clusters

在美国，平均每天都有三个社区达到足够的担忧状态，联系他们的州卫生部门调查一个疑似癌症集群，癌症的发生在空间和时间上都出现了不寻常和无法解释的增加。州卫生部门以这样或那样的方式调查了其中约三分之一的病例，但发现极少数(约1%)存在可疑的癌症发病率。然而，这些社区关注和卫生部门应对的案例为调查风险感知、风险沟通和公众参与风险分析提供了一个有效的环境。该项目是一项既定研究工作的延续和扩展，旨在调查公民发起的癌症集群调查周围的社会和心理环境，重点放在两个方面：国家卫生部门沟通的影响，以及公民和官员在这些情况下举行的公开会议的经历。为了实现第一个目标，该项目将整合和开发两个主要的理论模型，一个是风险感知的核心(心理测量学模型)，另一个是信息处理和决策的核心(启发式-系统模型)。这项工作之前的工作已经审查了一系列五个这样的案例。这一扩展将使用邮寄和电话调查方法来审查更大和更多样化的一组群集调查(约50项)，从而能够跨案例进行比较。分析将继续完善一个模型，该模型描述在这些案件中向社区提供的信息的影响，并将评估这些案件特有的特殊情况(例如，癌症类型、可疑原因)的影响。分析还将侧重于各州卫生部门用来传达其流行病学调查结果的不同通信技术。为了实现第二个目标，将对一组五个案例进行更深入的研究，重点放在公共会议上，这些会议几乎总是社区体验的一个重要特征。这项工作将进一步利用邮件和电话调查方法，还将利用广泛的访谈和专题小组。总体而言，该项目预计将提供详细的检查，了解在这些情况下信息是如何传达的，以及公民如何利用信息来达到或修改他们对癌症发病率的担忧。相对于风险感知中的科学兴趣，这项调查最有趣的方面之一在于，聚集性病例几乎总是呈现一种情况，在这种情况下，科学证据表明风险很小或没有风险，但这种评估是用癌症流行病学的概率语言表述的。这项调查将促进对个人如何应对这种形式的信息的科学理解，这是心理学、社会心理学和风险沟通领域长期关注的问题。从更实际的角度来看，该项目还旨在评估向社区提供这种形式的信息的方法。分析将阐明传达流行病学研究结果的更有效手段，并因此将为负责这项工作的人提供重要和有用的反馈。该项目的最终目标是，这类信息将被更有效地交流，涉及此类案件的社区将得到更好的服务。

Every day in the United States, on average, three communities reach asufficient state of concern to contact their state health department for theinvestigation of a suspected cancer cluste, ran unusual and unexplainedincrease in the occurrence of cancer in space and time. State healthdepartments investigate about a third of these cases in one way or another,but find that very few (about 1%) present suspect cancer rates. However,these cases of community concern and health department response present aneffective circumstance in which to investigate risk perception, riskcommunication, and public participation in risk analysis. This project isthe continuation and expansion of an established research effort designed toexamine the social and psychological circumstances surroundingcitizen-initiated cancer cluster investigations, with an emphasis on twoaspects: the effects of state health department communications, and theexperiences of citizens and officials in public meetings held during thesecases. To meet the first goal, the project will integrate, and develop, twoprimary theoretical models, one central to risk perception (the Psychometricmodel) and one central to information processing and decision making (theHeuristic-Systematic model). Previous work in this effort has examined aseries of five such cases. This expansion will use mail and phone surveymethods to look at a larger and more diverse set of cluster investigations(about 50), enabling a comparison across cases. The analysis will continuethe refinement of a model that describes the effects of information providedto communities in these cases, and will also evaluate the effects of thespecific circumstances unique to theses cases (e.g., types of cancer,suspected causes). The analysis will also focus on the differentcommunication techniques used by various state health departments to conveythe results of their epidemiological investigations. To meet the secondgoal, a set of five cases will be more deeply studied with an emphasis onthe public meetings that are almost always an important feature of thesecommunity experiences. That effort will make further use of mail and phonesurvey methods, and will also make use of extensive interviews and focusgroups. Overall, the project is expected to provide a detailed examinationof how information is conveyed in these cases, and how citizens make use ofinformation to reach, or modify, their orientation toward concerns aboutcancer rates.Relative to scientific interests in risk perception, one of the mostinteresting aspects of this investigation resides in the fact that clustercases almost always present a circumstance in which the scientific evidenceindicates little or no risk, yet that evaluation is couched in theprobabilistic language of cancer epidemiology. This investigation willadvance scientific understanding of how individuals react to this form ofinformation, a problem that has been a long-standing concern in the fieldsof psychology, social-psychology, and risk communication. In more practicalterms, this project is also designed to evaluate the methods by which thisform of information is provided to communities. The analysis will illuminatethe more effective means of communicating the results of epidemiologicalstudies and as such will provide important and useful feed-back for thosewho are charged with that work. The project's ultimate goal is that thiskind of information will be communicated more effectively and thecommunities involved in such cases will be better served.