Risk communication and public participation during the investigation of cancer clusters

点击翻译按钮获取中文摘要

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.