Projects

Life is fraught with hazards. However, the risk of many of these hazards can be reduced by performing protective behaviors. Acting appropriately to both stable and emerging or changing hazards requires humans to modify their protective behavior accordingly. It has been shown that risk perception is among the factors that are prerequisites for initiating protective behavior. Thus, when a new hazard emerges or the risk of a hazard changes, people presumably modify their risk perception accordingly, which in turn may promote the initiation of protective behaviors. This implies a dynamic interplay between risk, the perception of risk, and protective behaviors. The present dissertation aims at exploring aspects of this dynamic interplay for health risks.
The present dissertation first examined the association between health risk and risk perception. Three indicators of accuracy were examined for three infectious diseases, namely avian influenza, seasonal influenza, and the common cold. Specifically, conducting four cross-sectional surveys over a time period of 12 years showed that risk perceptions were concurrently accurate and inaccurate. While people held lower personal than general risk perceptions, indicating social inaccuracy (i.e., optimistic bias), the rank order between diseases was accurate at all four measurement points (i.e., general problem level accuracy), as people rated the risk for infection as highest for the common cold and lowest for avian influenza. Moreover, risk perceptions also accurately reflected the season and off-season times for seasonal influenza and common cold (i.e., dynamic problem level accuracy), although general risk perceptions reflected changes in the health risk to a greater extent. Thus, overall, people accurately modified their risk perceptions to changes in the general health risk.
The present dissertation then explored the relationship between health risk and protective behavior intentions. Specifically, it investigated whether increases in health risk were accompanied by increases in protective behavior intentions during the emerging phase of the Covid-19 pandemic in Germany. The analyses of three cross- sectional surveys indicated that intentions for social distancing and increasing personal hygiene increased in line with increases in health risk (i.e., total confirmed cases of Covid-19), whereas intentions to seek medical care increased at first but then decreased after the imposition of the lockdown in Germany. Moreover, small associations of age and intentions for protective behavior were revealed, which varied in accordance with the health risk. Specifically, age was positively associated with intentions for social distancing and personal hygiene in the early emergence of Covid- 19 in Germany, but this effect diminished after the imposition of the lockdown. However, a positive association of age and intention to visit a doctor only emerged after the imposition of the lockdown. Thus, people modified their protective behavior intentions as the health risk increased, and health risk moderated the small associations between age and protective behavior intentions.
Lastly, the interplay between protective behavior and risk perception in dependence of health risk was investigated. While the first two studies focused on infectious disease threats, the third study shifted the attention to noncommunicable diseases, specifically examining the interplay between self-reported healthy eating and diet-related risk perception in the context of providing personalized health feedback. Assessing the reciprocal relationship between self-reported healthy eating and diet- related risk perception for two groups of different feedback valence revealed relative and adaptive accuracy of perceived risk in both feedback groups. Specifically, people with higher perceived risk generally reported lower healthy eating (i.e., relative accuracy) and increases in self-reported healthy eating were followed by lower risk perception (i.e., adaptive accuracy). Thus, the same dynamic interplay between protective behavior and risk perception emerged for two degrees of health risk.
The findings of the present dissertation emphasize that people generally respond reasonably to changing health risks by modifying their risk perception and protective behavior intentions accordingly. Furthermore, the occurrence of changes in perceived risk after changes in self-reported protective behavior further highlights the dynamic nature of perceived risk. Overall, the findings of this dissertation provide an initial starting point for further research on the dynamic interplay between health risk, perceived risk, and protective behavior, to gain a more comprehensive understanding of the interactions between them. The further investigation of this interplay may contribute to a stronger focus on the reciprocal relationships between constructs and their dynamic interplay across time, which may foster the development of models and theories in health psychology that emphasize dynamics and reciprocal interrelations.

Risk information is information about the riskiness of certain behaviours and events or about people’s risk status and can indicate either a heightened or a low risk. Integrating this information into risk perceptions is an important prerequisite for engaging in preventive behaviour, if necessary. In some cases, however, people do not respond with increased risk perception to threatening risk information while in other cases reassuring risk information fails to reassure. Therefore, the present dissertation aims at exploring how people respond to risk information and what factors influence this response. To this end, responses to risk information from two frequent sources are examined: personalised health risk feedback and personal risk experience.
First, the dissertation examines responses to risk information from personalised health risk feedback and the role of pre-feedback expectations in information processing. Specifically, it is investigated in a longitudinal study whether unexpected feedback on actual cholesterol levels is accepted to a lesser degree than expected feedback. Risk perceptions are followed up over a period of six months in order to examine the long-term influence of pre-feedback expectations. The analyses show that expected positive and negative feedback is accurately reflected in decreased and increased risk perceptions, respectively. However, unexpected feedback is not generally accepted: both a ‘lack of concern’ as well as a ‘lack of reassurance’ are observed in people receiving either unexpected negative or positive feedback. Moreover, this pattern is still evident six months after the feedback is received. This indicates that pre-existing expectations have a lasting influence on the processing of personalised health risk information, potentially due to people’s strivings for consistency with their own health-related self-concept.
The dissertation then shifts the focus to the processing of risk information from personal experience. It is examined whether people distinguish between risk information that is relevant to themselves and such that is relevant to others (i.e. which target is addressed in the information), and whether this affects personal and general risk perceptions differently (i.e. risk to the self vs. risk to others). As part of a binational study conducted in Israel and Germany, responses to risk information gained through behavioural experience with lifestyle risks (i.e. alcohol consumption, tobacco consumption, and unhealthy eating) and acute hazard experience (terrorism) are investigated. Behavioural experience is predominantly informative for the self while terrorism experience is commonly also informative with regard to the risk to others. Accordingly, it is shown that personal but not general risk perceptions are heightened with more behavioural experience whereas terrorism experience is related to heightened personal and general risk perceptions. This suggests that people distinguish whether the risk information is relevant to themselves or to others, and adapt their risk perceptions accordingly.
Finally, the relationship between behavioural experience and personal risk perception is investigated more closely from a methodological perspective. A new measure for health risk perceptions – people’s perceived speed of ageing determined by their own lifestyle – is designed to assess lifestyle-related health risk perceptions. The study replicates the findings of a heightened personal risk perception with more behavioural experience of alcohol consumption and unhealthy eating and extends them to the domain of physical activity. It is shown that the measure reflects different lifestyle behaviour profiles, which supports its applicability in studies examining the relationship between behavioural experience and health risk perceptions.
The findings of the present dissertation contribute to a deeper understanding of responses to risk information from personalised risk feedback and from personal experience. It shows that both pre-existing expectations as well as the target addressed in the risk information play an important role as they influence how people process the information and integrate them into their risk perceptions. The findings thus highlight the importance of considering both people’s expectations and the target addressed in risk information when investigating responses to risk information as well as when providing people with information about their risk status. Together, this could improve the effectiveness of risk communication strategies as well as medical interventions in the interest of physical and mental health.