Is it worth the risk?: Risk perception R.Fielding Department of Community Medicine & Unit for Behavioural Sciences UNIVERSITY OF HONG KONG

Learning objectives define "perception" and its role in human behaviour. identify at least three of the defining features of the perceptual process outline the concept of risk and offer examples of common health risky behaviours (HRBs) give an account of the role of control and predictability in perception of risk give at least two examples of common influences that maintain health risky behaviour.

What is "perception”? The process of ascribing meaning to sensory and cortical activity such that the activity comes to acquire symbolic function. Perception is not the same as sensation (activity of the sensory nerves producing an experience of light, sound, touch, smell or taste). Sensation is innate, perception is learned. Perception enables environmental and social interaction via learning and memory.

Features of perceptual process Selectivity of attention Constancy of sensory characteristics (colour, shape, size, brightness) Organization Rule bound (illusions) Context & past experience - –same stimulus may be perceived differently when context is changed; –different people may perceive same stimulus differently when context is constant.

Risk “To incur the chance of unfortunate consequences by doing something.” (Chambers 20th C. Dictionary) Hazard: potential cause of harm Benefit: gain of desired outcome Health risky behaviours in HK? : Smoking: Drink-driving:

Control and predictability Control - ability to influence desired outcomes

HRB and perception of risk 994 Asian female air crew: Lower general health risk perceived among less experienced than experienced crew. Lower smoking risks perceived by inexperienced smokers than experienced smokers. Smokers twice as likely to anticipate benefits from smoking than non-smokers. (Li et al, 1996). 205 Australian teens: smokers perceived less personal risk, less severe health consequences, greater benefits relative to risks, found it more difficult to picture harmful consequences to themselves, and perceived smoking to be less avoidable.(Virgili et al, 1991).

Perceived vulnerability 282 Mexican farm workers - pesticide exposure -greater risk perceptions were associated with beliefs that past harm had occurred, future harm to self or offspring was likely, precautions were less effective, and cancer-causing agents were mostly unavoidable. (Vaughan, 1993). 14% of male and 10% of female HKU undergraduates have intercourse by Yr. 3. Of whom 26% males and 20% females use condoms “not at all”. (Abdullah et al, 1998).

Distortion of risk vs hazard Current risk over estimated, future risk underestimated (discounted?).

HRB maintenance Modified perception of risk (see above) Lack of knowledge of health risk Low self-efficacy to change Peer pressure Lack of control over risk contingencies Distortion of risk perception vs. hazard probability

Common maintenance influences in HK Prevalence of the HRB / tradition Marketing influences - e.g. tobacco advertising Status signifiers (e.g. red wine/ cognac/ cigars) Lack of adequate information on hazard or alternatives

Conclusions Risk perception influenced by - –value systems –prevalence of behaviour –perceived lack of control –experience with hazard

Questions: List three influences that maintain health risk behaviours Use an example to summarize the interaction between perception of risk associated with a HRB and participating in that HRB. Give two examples of group differences in perceptions of likelihood to participate in health risky behaviours. Differentiate perception from sensation.

References: Unpublished doctoral thesis. Abdullah AS, University of Hong Kong A psychometric study of adolescent risk perception. Benthin-A; Slovic-P; Severson-H J-Adolesc Jun; 16(2): Risk-perception: differences between adolescents and adults. Cohn-LD; Macfarlane-S; Yanez-C; Imai-WK Health- Psychol May; 14(3): An examination of gender differences in traffic accident risk perception. DeJoy-DM Accid-Anal-Prev Jun; 24(3):