COMMUNICATING MULTIPLE DISEASE RISKS: A TRANSLATION OF RISK PREDICTION SCIENCE

 描述(申请人提供)：流行病学寻求通过确定癌症和其他疾病的风险因素来改善公共健康。然而，公众并不总是使用这些信息来做出适当的健康决定。一个原因可能是，尽管一个单一的风险因素可能会影响多种疾病的风险，但这些信息很少以一种优化人们对单一健康行为重要性的理解的方式进行交流。帮助人们了解一种单一的行为如何影响他们患多种疾病的风险，可以培养出一幅更连贯、更有意义的图景，说明这种行为在降低健康风险、增加参与行为的动机和意图以及最终改善公共健康方面的重要性。这项研究的目的是将关于体力活动不足(即结肠癌、乳腺癌[女性]、心脏病、糖尿病和中风)的五个主要健康后果的流行病学数据转换为视觉显示，以一种对不同的非专业受众理解和有意义的方式传达个性化的风险估计。其目的是1)确定四种风险沟通策略的哪一种组合最有效地传达与缺乏运动相关的五种疾病的风险估计，以及2)将这些策略合并到视觉展示中并比较其有效性 转换为字母数字文本。研究设计，包括主要和次要结果的确定和优先顺序，以健康行为理论为指导。样本将由大约50%的种族/少数民族群体成员组成，50%的成员不超过高中文凭。参与者将从两个来源招募：GfK知识网络互联网小组(N=1130)和中西部一个大城市(N=392)。目标1的参与者将被随机分配到8个实验条件中的一个，采用2x2x2完全析因设计。条件将根据风险估计是否作为定性描述符(例如，高风险)与数字估计来传达、社会比较信息的存在/不存在(即，他们的风险与普通人相比如何)以及风险降低信息的存在/不存在而变化。AIM 2将采用随机对照试验。这两个目标的主要结果将是对风险的理解和增加体力活动的意图。次要结果将是认知和情感感知的可能性、反应效率、感知的严重性和担忧(目标1和目标2)，以及在90天随访时参与体力活动(目标2)。将审查潜在的主持人(即种族/族裔、教育程度、计算能力)和调解人(例如，反应效力)以实现这两个目标。实现这些目标将通过以下方式影响公共卫生：1)多功能视觉展示，可用于传达多个领域的多种健康风险；2)可集成到个人、社区或临床干预中的功能风险评估工具；3)增加基础和应用科学知识。这项研究还可能有助于缩小健康差距；其重点是了解人口统计主持人，这将增加展示对代表性不足群体的适用性。

 DESCRIPTION (provided by applicant): Epidemiology seeks to improve public health by identifying risk factors for cancer and other diseases. Yet, the public does not always use that information to make appropriate health decisions. One reason might be that, even though a single risk factor can affect the risk of multiple diseases, this information is seldom communicated in a way that optimizes people's understanding of the importance of engaging in a single healthy behavior. Helping people understand how a single behavior could affect their risk of multiple diseases could foster a more coherent and meaningful picture of the behavior's importance in reducing health risks, increase motivation and intentions to engage in the behavior, and eventually improve public health. The objective of this study is to translate epidemiological data about five major health consequences of insufficient physical activity (i.e., colon cancer, breast cancer [women], heart disease, diabetes, and stroke) into a visual display that conveys individualized risk estimates in a way that is understandable and meaningful to diverse lay audiences. The aims are to 1) Identify which combination of four risk communication strategies most effectively conveys risk estimates of five diseases associated with physical inactivity, and 2) Incorporate these strategies into a visual display and compare its effectiveness to alphanumeric text. The study design, including identification and prioritization of primary and secondary outcomes, was guided by health behavior theory. The sample will be comprised of approximately 50% members of racial/ethnic minority groups and 50% with no more than a high school diploma. Participants will be enrolled from two sources: the GfK Knowledge Networks Internet Panel (N=1130) and a large Midwestern city (N=392). Participants in Aim 1 will be randomly assigned to one of eight experimental conditions in a 2x2x2 full factorial design. The conditions will vary according the whether the risk estimate is conveyed as a qualitative descriptor (e.g., high risk) vs. a numerical estimate, the presence/absence of social comparison information (i.e., how their risk compares to the average person), and the presence/absence of risk reduction information. Aim 2 will utilize a randomized controlled trial. Primary outcomes for both aims will be risk comprehension and intentions to increase physical activity. Secondary outcomes will be cognitive and affective perceived likelihood, response efficacy, perceived severity, and worry (Aims 1 and 2), and engagement in physical activity at 90-day follow-up (Aim 2). Potential moderators (i.e., race/ethnicity, education, numeracy) and mediators (e.g., response efficacy) will be examined for both aims. Completing the aims will impact public health by providing: 1) a versatile visual display that can be adapted to communicate multiple health risks in several domains, 2) a functional risk assessment tool that can be integrated into individual, community, or clinical interventions, and 3) increased basic and applied scientific knowledge. This research may also contribute to the reduction of health disparities; its focus on understanding demographic moderators will increase the applicability of the display to underrepresented groups.