Meg Gerrard

Meta-Analysis of the Relationship Between Risk Perception and Health Behavior: The Example of Vaccination

BACKGROUNDnRisk perceptions are central to many health behavior theories. However, the relationship between risk perceptions and behavior, muddied by instances of inappropriate assessment and analysis, often looks weak.nnnMETHODnA meta-analysis of eligible studies assessing the bivariate association between adult vaccination and perceived likelihood, susceptibility, or severity was conducted.nnnRESULTSnThirty-four studies met inclusion criteria (N = 15,988). Risk likelihood (pooled r = .26), susceptibility (pooled r = .24), and severity (pooled r = .16) significantly predicted vaccination behavior. The risk perception-behavior relationship was larger for studies that were prospective, had higher quality risk measures, or had unskewed risk or behavior measures.nnnCONCLUSIONSnThe consistent relationships between risk perceptions and behavior, larger than suggested by prior meta-analyses, suggest that risk perceptions are rightly placed as core concepts in theories of health behavior.

Predicting young adults' health risk behavior.

A prototype model of risk behavior is described and was tested in a longitudinal study of 679 college students, beginning at the start of their freshman year. Perceptions of the prototype associated with 4 health risk behaviors (smoking, drinking, reckless driving, and ineffective contraception) were assessed along with self-reports of the same behaviors. Results indicated that prototype perception was related to risk behavior in both a reactive and a prospective manner. That is, perceptions changed as a function of change in behavior, and perceptions predicted those behavior changes as well. This prospective relation was moderated by social comparison, as the link between perception and behavior change was stronger among persons who reported frequently engaging in social comparison.

The Influence of Neighborhood Disadvantage, Collective Socialization, and Parenting on African American Children's Affiliation with Deviant Peers

This study focused on hypotheses about the contributions of neighborhood disadvantage, collective socialization, and parenting to African American childrens affiliation with deviant peers. A total of 867 families living in Georgia and Iowa, each with a 10- to 12-year-old child, participated. Unique contributions to deviant peer affiliation were examined using a hierarchical linear model. Community disadvantage derived from census data had a significant positive effect on deviant peer affiliations. Nurturant/involved parenting and collective socialization processes were inversely associated, and harsh/inconsistent parenting was positively associated, with deviant peer affiliations. The effects of nurturant/involved parenting and collective socialization were most pronounced for children residing in the most disadvantaged neighborhoods.

Reasoned action and social reaction : Willingness and intention as independent predictors of health risk

Three studies are described that assess elements of a new model of adolescent health-risk behavior, the prototype/willingness (P/W) model (F. X. Gibbons & M. Gerrard, 1995, 1997). The 1st analysis examined whether a central element of the prototype model, behavioral willingness, adds significantly to behavioral expectation in predicting adolescents smoking behavior. The 2nd set of analyses used structural-equation-modeling procedures to provide the 1st test of the complete model in predicting college students pregnancy-risk behavior. Finally, the 3rd study used confirmatory factor analysis to assess the independence of elements of the model from similar elements in other health behavior models. Results of the 3 studies provided support for the prototype model and, in particular, for 2 of its primary contentions: (a) that much adolescent health-risk behavior is not planned and (b) that willingness and intention are related but independent constructs, each of which can be an antecedent to risk behavior.

Perceived discrimination and substance use in African American parents and their children: a panel study.

The relation between perceived racial discrimination and substance use was examined in a panel of 684 African American families, using the prototype-willingness model of adolescent health risk (F. X. Gibbons, M. Gerrard, & D. Lane, 2003). Discrimination was concurrently and prospectively related to use in the parents and the children (mean age=10.5 years at Wave 1). The discrimination-->use relation in the parents was mediated by distress (anxiety and depression). Among the children, the relation was mediated by distress as well as their risk cognitions (favorability of their risk images and their willingness to use) and the extent to which they reported affiliating with friends who were using substances. Each of these relations with discrimination was positive. In contrast, effective parenting was associated with less willingness and intention to use. Theoretical and applied implications of the results are discussed.

Relation Between Perceived Vulnerability to HIV and Precautionary Sexual Behavior

Although virtually all major theories of health-protective behavior assume that precautionary behavior is related to perceived vulnerability, the applicability of this assumption to human immunodeficiency virus (HIV) preventive behavior has recently been called into question. This article uses qualitative and quantitative methods to review and integrate the literature relevant to the relation between perceived vulnerability to HIV and precautionary sexual behavior. Specifically, the purpose of the article is to determine whether the extent research supports 2 hypotheses regarding this relation; (a) Perceptions of personal vulnerability to HIV are reflections of current and recent risk and precautionary behavior, and (b) these perceptions motivate precautionary sexual behavior. In addition, it examines the conceptual and methodological strengths and weaknesses of the empirical literature on these questions and provides recommendations for future research.

A Longitudinal Study of the Reciprocal Nature of Risk Behaviors and Cognitions in Adolescents: What You Do Shapes What You Think, and Vice Versa

Adolescents reckless driving, drinking, and smoking, along with their cognitions about these behaviors, were assessed in a 3-year longitudinal design. Consistent with most models of health behavior, the results indicated that health cognitions predict risk behavior. In addition, the current data demonstrate that increases in risk behavior are accompanied by increase in perceptions of vulnerability and prevalence and by decreases in the influence of concerns about health and safety. Furthermore, the changes in prevalence estimates and concern about health and safety predicted subsequent risk behavior. These results demonstrate reciprocity between risk behaviors and related cognitions and suggest that adolescents are aware of the risks associated with their behavior but modify their thinking about these risks in ways that facilitate continued participation in the behaviors.

Risk Perceptions: Assessment and Relationship to Influenza Vaccination

OBJECTIVEnAccurate measurement of beliefs about risk probability is essential to determine what role these beliefs have in health behavior. This study investigated the ability of several types of risk perception measures and of other constructs from health behavior theories to predict influenza vaccination.nnnDESIGNnProspective study in which students, faculty, and staff at 3 universities (N = 428) were interviewed in the fall, before influenza vaccine was available, and again early in the next calendar year.nnnMAIN OUTCOME MEASUREnSelf-reported influenza vaccination.nnnRESULTSnTwo interview questions that asked about feeling at risk and feeling vulnerable predicted subsequent behavior better (r = .44, p = .001) than 2 questions that asked for agreement or disagreement with statements about risk probability (r = .25, p = .001) or 4 questions that asked respondents to estimate the magnitude of the risk probability (r = .30, p = .001). Of the 4 perceived risk magnitude scales, a 7-point verbal scale was the best predictor of behavior. Anticipated regret was the strongest predictor of vaccination (r = .45, p = .001) of all constructs studied, including risk perceptions, worry, and perceived vaccine effectiveness.nnnCONCLUSIONnRisk perceptions predicted subsequent vaccination. However, perceived risk phrased in terms of feelings rather than as a purely cognitive probability judgment predicted better. Because neither feeling at risk nor anticipated regret is represented in the most commonly used theories of health behavior, the data suggest that these theories are missing important constructs.

Family communication and religiosity related to substance use and sexual behavior in early adolescence: A test for pathways through self-control and prototype perceptions

This research tested predictions about pathways to substance use and sexual behavior with a community sample of 297 African American adolescents (M age: 13.0 years). Structural modeling indicated that parent-adolescent communication had a path to unfavorable prototypes of substance users; quality of parent-adolescent relationship had paths to good self-control, higher resistance efficacy, and unfavorable prototypes of sexually active teens; and religiosity had inverse direct effects to both substance use and sexual behavior. Self-control constructs had paths to prototypes of abstainers, whereas risk taking had paths to prototypes of drug and sex engagers and direct effects to outcomes. Prototypes had paths to outcomes primarily through resistance efficacy and peer affiliations. Effects were also found for gender, parental education, and temperament characteristics. Implications for self-control theory and prevention research are discussed.

Using UV photography to reduce use of tanning booths: a test of cognitive mediation.

Two laboratory studies were conducted in which a new type of intervention was used to reduce ultraviolet radiation (UV) exposure from tanning booth use among college students (Time 1 Ns=70 and 134). The intervention uses UV photography to highlight the damage to facial skin caused by previous UV exposure. When the authors controlled for baseline measures of booth use, students in both studies who viewed their UV photographs reported less booth use at a follow-up session 3-4 weeks later than did students not shown a copy of their photograph. Also, in both studies, the decline in use was significantly mediated by a Tanning Cognition Index composed of variables suggested by the prototype-willingness (prototype) model of health risk: tanning attitudes, tanner prototypes, and willingness to engage in risky UV exposure.