Mental health has worsened, and substance use has increased for some people during the coronavirus (COVID-19) pandemic. Some cross-sectional studies suggest that higher COVID-19 risk perceptions are related to poorer mental health and greater risk behaviours (e.g., substance use). However, longitudinal and genetic data are needed to help to reduce the likelihood of reverse causality.

Most conventional measures of risk perception such as perceived likelihood address largely deliberative or cognitive perceptions of vulnerability. Nevertheless, perceptions of vulnerability such as worry may have different antecedents and consequences than do these conventional measures, serve as stronger predictors of behavior, and qualify effects of conventional deliberative risk perceptions on behavior. In this study, we assessed how worry - the most common measure of affective perceptions of vulnerability compared with three conventional measures of risk (absolute risk, comparative risk, and conditional risk) in predicting behavioral intentions. Participants were 83 adults with type 2 diabetes who assessed their risk of heart disease and reported their intentions to increase physical activity (which reduces heart disease risk). As predicted, worry was the only significant predictor of exercise intentions such that higher worry was associated with higher intentions. Importantly, this relationship was stronger among individuals who perceived their absolute risk to be relatively higher and those who perceived their comparative risk to be relatively lower, demonstrating that cognitive and affective perceptions interact. These findings highlight the importance of not conflating affective and cognitive perceptions of vulnerability when assessing perceived risk, and suggest the need for more research on how to best conceptualize perceived risk in different samples and settings.

Translational development - in the sense of translating a mature methodology from one area of application to another, evolving area - is discussed for the use of benchmark doses in quantitative risk assessment. Illustrations are presented with traditional applications of the benchmark paradigm in biology and toxicology, and also with risk endpoints that differ from traditional toxicological archetypes. It is seen that the benchmark approach can apply to a diverse spectrum of risk management settings. This suggests a promising future for this important risk-analytic tool. Extensions of the method to a wider variety of applications represent a significant opportunity for enhancing environmental, biomedical, industrial, and socio-economic risk assessments.

Recent research suggests that emotion, affect, and cognition play important roles in risk perception and that their roles in judgment and decision-making processes may change over the lifespan. This paper discusses how emotion and affect might help or hinder risk communication with older adults. Currently, there are few guidelines for developing effective risk messages for the world's aging population, despite the array of complex risk decisions that come with increasing age and the importance of maintaining good decision making in later life. Age-related declines in cognitive abilities such as memory and processing speed, increased reliance on automatic processes, and adaptive motivational shifts toward focusing more on affective (especially positive) information mean that older and younger adults may respond differently to risk messages. Implications for specific risk information formats (probabilities, frequencies, visual displays, and narratives) are discussed and directions for future research are highlighted.

Studies of fish consumption focus on recreational or subsistence fishing, on awareness and adherence to advisories, consumption patterns, and contaminants in fish. Yet the general public obtains their fish from commercial sources. In this paper I examine fish consumption patterns of recreational fishermen in New Jersey to determine: 1) consumption rates for self-caught fish and for other fish, 2) meals consumed per year, 3) average meal size, and average daily intake of mercury, and 4) variations in these parameters for commonly-consumed fish, and different methods of computing intake. Over 300 people were interviewed at fishing sites and fishing clubs along the New Jersey shore. Consumption patterns of anglers varied by species of fish. From 2 to 90 % of the anglers ate the different fish species, and between 9 and 75 % gave fish away to family or friends. Self-caught fish made up 7 to 92 % of fish diets. On average, self-caught fish were eaten for only 2 to 6 months of the year, whereas other fish (commercial or restaurant) were eaten up to 10 months a year. Anglers consumed from 5 to 36 meals of different fish a year, which resulted in intake of mercury ranging from 0.01 to 0.22 ug/kg/day. Average intake of Mako shark, swordfish, and tuna (sushi, canned tuna, self-caught tuna) exceeded the U.S. Environmental Protection Agency's oral, chronic reference dose for mercury of 0.1 ug/kg/day. However, computing intake using consumption for the highest month results in average mercury intake exceeding the reference dose for striped bass and bluefish as well. These data, and the variability in consumption patterns, have implications for risk assessors, risk managers, and health professionals.

Governmental officials, health and safety professionals, early responders, and the public are interested in the perceptions and concerns of people faced with a crisis, especially during and immediately after a disaster strikes. Reliable information can lead to increased individual and community preparedness for upcoming crises. The objective of this research was to evaluate concerns of coastal and central New Jersey residents within the first 100 days of Superstorm Sandy's landfall. Respondents living in central New Jersey and Jersey shore communities were differentially impacted by the storm, with shore residents having higher evacuation rates (47% vs. 13%), more flood waters in their homes, longer power outages (average 23 vs. 6 days), and longer periods without Internet (29 vs. 6 days). Ratings of concerns varied both among and within categories as a function of location (central vs. coastal New Jersey), stressor level (ranging from 1 to 3 for combinations of power outages, high winds, and flooding), and demographics. Respondents were most concerned about property damage, health, inconveniences, ecological services, and nuclear power plants in that order. Respondents from the shore gave higher ratings to the concerns within each major category, compared to those from central Jersey. Four findings have implications for understanding future risk, recovery, and resiliency: (1) respondents with the highest stressor level (level 3) were more concerned about water damage than others, (2) respondents with flood damage were more concerned about water drainage and mold than others, (3) respondents with the highest stressor levels rated all ecological services higher than others, and (4) shore respondents rated all ecological services higher than central Jersey residents. These data provide information to design future preparedness plans, improve resiliency for future severe weather events, and reduce public health risk.

The precautionary principle is a dominant paradigm governing risk-based decision-making. Today, there are increasing pressures to re-examine aggressive precautionary approaches, and to assess how the principle should be applied in the modern system. In this paper, we examined three key applications of precautionary approaches in the field of transfusion medicine to provide insight into the risks and benefits of these approaches. The three case studies examined were the donor deferral policies to safeguard against transfusion transmission of human immunodeficiency virus, variant Creutzfeldt-Jacob disease, and, lastly, xenotropic murine leukemia virus-related virus. Characterization of precautionary applications was conducted using an embedded case study design. Our findings indicate that transfusion transmission mitigation strategies have become increasingly aggressive in the face of theoretical risks. In contrast, the review processes for implementation and reversal of precautionary policies have been slow, and historical donor deferral policies are still in place today. Application of precautionary approaches has proved challenging with both benefits and pitfalls. In light of emerging threats to the blood system, policy-makers should consider the implementation of frameworks to guide the appropriate application of precaution in transfusion medicine in the future.

Following the 2010 Gulf Oil Spill, area pregnant women were thought to be at-risk for poor health outcomes from the stress of managing health actions in this post-disaster environment. Research directed by an ongoing community- academic partnership sought to explore the specific role of culture in environmental risk protection actions among low-income pregnant women. As a part of the first-phase of a mixed-methods cultural study, community health workers (CHWs) used freelisting methods to survey low-income, first-time mother ( = 20) for the threats in the environment and relevant protective actions. Then, a separate pile sort activity ( = 31) was used to further investigate these cultural topics. Results elicited a diverse range of threats, protective actions, and sources of support across socio-demographic groups. Results also showed a culturally tailored conceptualization of threats in the environment. Exploring beliefs among a diverse population helps to uncover cultural differences in a population. Results will aid in developing culturally tailored policies and interventions, and increase the relevance of such interventions to address community concerns. Moreover, incorporating CHWs into the research process enhanced researcher literacy, and fostered mutual trust between the community and researchers.

Trust is generally recognized as important for risk-relevant behavior but research suggests that trust in different organizations may have varying effects. This research advances the literature by testing two hypotheses which postulate that this variability can be explained by risk perception. We collected data from 351 anglers regarding their trust in nine organizations whose efforts are relevant to dioxin contamination in Michigan's Saginaw Bay Watershed, risk perceptions, and self-reports of risky behavior (i.e., consumption of local fish identified as especially likely to contain contaminants). As hypothesized (H1), the negative effect of trust in two agencies-the Michigan Department of Natural Resources (MDNR) and a Michigan Department of Health and Human Services-sponsored River Walker Program (RWP)-on risky behavior was significantly mediated by risk perception but these effects differed from each other such that trust in the MDNR was associated with increased perceptions of risk while trust in the RWP was associated with decreased perceptions of benefit. Also as hypothesized (H2), the positive effect of trust in Dow Chemical Company on risky behavior was significantly mediated by risk perception such that increased trust in Dow was associated with reduced risk perception. The current results lend credence to arguments regarding the importance of specificity in the target of trust and advance this literature by suggesting that differential effects on risk perception help explain this variability. Thus, organizations whose efforts focus on risk communication appear ideally situated to reduce risky behavior through a negative impact on risk perception. Other organizations, however, may run the risk of risky behavior if their efforts result in reduced perceptions of risk.

Flood preparedness of private households is regarded an essential building block of integrated flood risk management. In the past decade, numerous empirical studies have employed the protection motivation theory (PMT) to explain flood mitigation behavior at the household level. However, much of this research has produced mixed results and could not consistently confirm the strength and direction of the relationships between the PMT components. Based on a survey of 2,007 households in flood-prone areas, this study revisits the model structure of the PMT by means of structural equation modeling. Compared to the methods used in previous studies, this modeling technique allows us to capture the PMT components in greater detail and to comprehensively test their hypothesized interrelations. Our results point to two separate routes leading to two different response types: A protective route from coping appraisal to protective behavior, and a non-protective route from threat appraisal to non-protective responses. Risk perception is not found to be part of the protective route, neither are non-protective responses confirmed to undermine protection motivation. The two separate routes are observed consistently across all combinations of the six protective and four non-protective responses assessed in this study. In the light of encouraging private flood adaptation, risk communication measures should specifically target the protective route and avoid (accidentally) providing incentives that fall within the non-protective route. This cross-sectional study, however, cannot establish how the two routes interrelate over time. More experimental and longitudinal research is required to address potential feedback effects and the role of decision stages.

The environmental health risk assessment process informs clean-up activities at hazardous waste sites. Ensuring this process is accessible and transparent to communities is crucial for environmental health literacy initiatives. The goals of this project were to develop plain language and effective visuals that can be used when communicating the risk assessment process and methods used to predict excess cancer risk(s) due to environmental exposures. In this study, a community factsheet entitled, "Understanding Environmental Health Risk Assessment" was developed and a participatory design and formative evaluation approach was implemented with a set of representative users ( = 11). Community members living in the vicinity of two Arizona hazardous waste sites as well as three public health professionals/researchers were asked to evaluate the functionality and accessibility of the factsheet, particularly the graphics and whether the text was written in plain language. Participant responses revealed the following major findings: 1) form follows function, 2) graphic elements should outweigh text, 3) line of sight and layout is critical to information accessibility, 4) color coding dramatically aids the reader, 5) content should be strategically grouped, 6) concepts per figure should be minimized to ensure comprehension, 7) interactive content is preferred over static content, and 8) communication efforts need to interweave new information with the targeted audience's past and current environmental health understandings to aid in their ability to retain new concepts. Based on participant feedback, new and improved layout decisions, infographics and accompanying text were designed and prepared. This research demonstrates the need and importance of participatory design, information design prototyping, formative evaluation, and a cultural model of risk communication.

Currently, one of the most pressing public health challenges is encouraging people to get vaccinated against COVID-19. Due to limited supplies, some people have had to wait for the COVID-19 vaccine. Consumer research has suggested that people who are overlooked in initial distribution of desired goods may no longer be interested. Here, we therefore examined people's preferences for proposed vaccine allocation strategies, as well as their anticipated responses to being overlooked. After health-care workers, most participants preferred prioritizing vaccines for high-risk individuals living in group-settings (49%) or with families (29%). We also found evidence of reluctance if passed over. After random assignment to vaccine allocation strategies that would initially overlook them, 37% of participants indicated that they would refuse the vaccine. The refusal rate rose to 42% when the vaccine allocation strategy prioritized people in areas with more COVID-19 - policies that were implemented in many areas. Even among participants who did not self-identify as vaccine hesitant, 22% said they would not want to vaccine in that case. Logistic regressions confirmed that vaccine refusal would be largest if vaccine allocation strategies targeted people who live in areas with more COVID-19 infections. In sum, once people are overlooked by vaccine allocation, they may no longer want to get vaccinated, even if they were not originally vaccine hesitant. Vaccine allocation strategies that prioritize high-infection areas and high-risk individuals in group-settings may enhance these concerns.

Prior research on how to improve the effectiveness of information security warnings has predominantly focused on either the informational content of warnings or their visual saliency. In an online experiment ( = 1'486), we disentangle the effect of both manipulations and demonstrate that both factors simultaneously influence decision making. Our data indicate that the proportion of people who engage in protection behavior can be increased by roughly 65% by making a particular warning message more visually salient (i.e. a more conspicuous visual design is used). We also show that varying the message's saliency can make people behave very differently when confronted with the same threat or behave very similarly when confronted with threats that differ widely in terms of severity of outcomes. Our results suggest that the visual design of a warning may warrant at least as much attention as the informational content that the warning message conveys.

In the Netherlands, intensive livestock farming is a recurrent topic of societal debate with stakeholders having quite different perspectives on the benefits and harms. In particular, stakeholders appear to have different perceptions on the risks to human and animal health. This paper reports a quantitative analysis of a survey on the perceptions of risks and benefits of intensive livestock farming conducted among the general public, including people living in livestock dense municipalities ( = 808), farmers ( = 237) and other stakeholders ( = 367). Results show that farmers and citizens have contrasting views about the benefits and concerns and in particular about the risks of intensive livestock farming for human health as well as animal well-being. People living in livestock dense communities held a somewhat more positive view than the general public, yet odour hinder and air quality was perceived as a serious health problem, but not by farmers. These differences in risk perceptions may well be explained from differences in interest, experience and options for control of potential hazards. Our study reflects more than just the perceived risks related to intensive livestock farming, but also reveal the global and multidimensional legitimate concerns and views on what matter to different groups of people. We argue that these differences in risk perspectives should be taken into account when communicating about human health risks, and should also be more explicitly addressed in discussions about the risks of intensive livestock farming in order to develop more inclusive policies that are supported by stakeholders.

Several studies suggest that "don't know" (DK) responses to risk perception items may represent meaningful expressions of uncertainty about disease risk. However, researchers are often discouraged from including a DK response option in survey items due to concerns about respondents overusing it to minimize cognitive effort-a phenomenon often referred to as . Our objective was to investigate whether patterns of DK responses to risk perception survey items were consistent with satisficing behavior. We conducted a secondary analysis of survey data from 814 parents and guardians (hereafter ) of children with asthma. Caregivers answered 18 items assessing their perceived risk of their child experiencing two types of poor asthma outcomes: asthma exacerbation, and low asthma control. We examined differences in the frequency and distribution of DK responses across all 18 items and by type of risk perception item (i.e., 2 5 response options, absolute comparative risk). We found that 32% (=548) of respondents marked DK at least once. Of the 266 caregivers who provided DK response, most did so for only 1 or 2 items (51.9%, =138), and only 6% (=15) answered DK to more than half of the items. Using random coefficient Poisson models, we found more DK responding for dichotomous absolute (30.1%) than ordinal absolute items (5.3%), =1.72, <.001. We also found fewer DK responses to the ordinal absolute items than the comparative items (8.2%), =-0.49, <.001. Using Chi-square tests, we found that inattentive responding was not associated with responding DK. Our findings suggest that satisficing is unlikely to completely explain DK responding to perceived risk survey items. Researchers who exclude DK response options from risk perception survey items may obtain an incomplete understanding of their study sample's beliefs about risk.

Many lands were degraded or destroyed by human activities, including contamination from industry and military facilities. The United States and other industrialized counties have legacy wastes remaining from the Second World War, the Cold War, and industrialization. There is increasing need to return degraded land to suitable future land uses, including ecological parks and preserves. This paper proposes a conceptual model of the different levels of information needed to understand the risk to human health, the environment, and ecological resources. I propose a four-part approach: 1) general model for assessing ecological resources, 2) model for assessment needed for remediation or restoration projects, 3) a sliding scale, conceptual model for causes, events, and sources that lead to exposure and risk, and 4) an additional step that includes environmental justice (equity, diversity and inclusion) as a necessary consideration of traditional exposure assessment. While the factors involved in ecological risk assessment are well established, the combination of human health, ecological health, and environmental justice determining risk for remediation or restoration projects is not. Major factors useful for human health, environmental, and ecological evaluation include causes, events (earthquakes, accidents, chemical releases), sources, exposure, and informational challenges, as well as barriers to exposure. I propose that exposure through an environmental justice (diversity, equity, and inclusion) lens should be a key component of risk assessment. Each of these factors involves a sliding scale or continuum that must be considered in evaluating risk and communicating with the regulators, resource trustees, land managers and the public. The conceptual model also serves as a template for obtaining information about the environment that will be useful for communicating the importance of different risk factors. The model was developed for consideration of remediation on Department of Energy lands, it can be applied more broadly to other projects.