Risk and health communication
Lieke Brekelmans
Artikel 1: The role of conspiracy beliefs for COVID-19 health responses
COVID-19 conspiracy theories include ideas that the virus is a hoax, was created deliberately,
or is being used for political control.
Health-protective behaviours
- Actions taken to protect oneself or others form illness
- Mask wearing
- Social distancing
- Vaccination
Health-endangering behaviours
- Actions that increase the risk of spreading or contracting COVID-19
- Rejecting vaccines
- Refusing to follow health guidelines
Conspiracy beliefs were negatively related to health-protective behaviours.
Positive relationship with health-endangering behaviours.
Beliefs affected intentions and actual behaviours
- The more someone believed in conspiracy theories, the lower their intention to
vaccinate and the higher their likelihood to engage in risky behaviour.
Motivated reasoning
- The tendency to fit new information into existing beliefs and desires, rather than
objectively assessing evidence
- People believe in conspiracies because it helps them maintain existing worldviews or
reduce anxiety in uncertain times
Health belief model (HBM)
- Suggests people take health actions if they:
o Feel susceptible to a disease
o Believe it would have severe consequences
o Think actions will reduce risk
o Face new barriers to actions
- Conspiracy beliefs can undermine all four elements, making people feel less
vulnerable or sceptical about preventive actions
Information deficit model
- Assumes that misinformation or lack of knowledge leads to poor decisions
, - However, the study shows that beliefs are often emotionally and ideologically
motivated, not just based on missing facts
Beliefs in conspiracy theories poses a significant barriers to effective pandemic response.
Artikel 2: Cognitive determinants of health behaviour
Health cognitions
- Thoughts and feelings people associate with health-related behaviour
Social cognition models (SCM)
- Psychological models that explain behaviour through individual cognitive processes
(perceptions, beliefs and attitudes) rather than through external structural factors
- Core assumption: behaviour is guided more by an individual’s perception of reality
than by the objective reality
- Psychological theories designed to understand how individual thought processes
influence health behaviour
Self-regulation theory
- SCMs are part of self-regulation research
- Investigates how people monitor, evaluate and alter their thoughts and behaviours to
align with personal goals
Self-regulation phases
1. Motivational phase:
a. Involves forming intentions by weighing costs and benefits of actions
2. Volitional phase:
a. Involves planning and executing actions to meet set goals
SCMs largely emphasize the motivational phase, but some incorporate volitional techniques
like implementation intentions.
Health belief model (HBM)
- One of the earliest and most widely used SCMs
- Developed to understand behaviours like screening uptake
- Core components:
1. Perceived susceptibility:
a. Belief about the likelihood of getting a disease
b. How likely am I to get cancer?
2. Perceived severity:
a. Belief about the seriousness of the disease and its consequences
b. How bad would it be if I got it?
3. Perceived benefits:
a. Belief in the efficacy of the advised behaviour to reduce risk of severity
b. Will quitting smoking actually help me?
, 4. Perceived barriers:
a. Beliefs about the costs or obstacles to performing the behaviour
b. Is it too difficult or expensive to get screening?
- Additional components:
5. Cues to action:
a. Triggers (internal of external) that activate readiness to act
b. Media campaigns or experiencing symptoms
6. Health motivations:
a. A stable trait indicating a person’s general concern and motivation to maintain
health
A person is more likely to perform a health behaviour if they:
1. Feel susceptible to a serious condition
2. Believe the action is beneficial
3. Believe benefits outweigh the barriers
4. Encounter a cue to act
Susceptibility and barriers are the strongest predictors across behaviours.
Perceived susceptibility and barriers completely mediated the effect of social class on
cervical screening uptake.
Criticism om HBM
- The original model omits some important predictors of behaviour, such as self-
efficacy
Extended health belief model
- Other model that adds:
1. Self-efficacy:
a. Confidence in one’s ability to perform a behaviour
b. The belief in one’s capacity to take actions
, 2. Intention:
a. Recognizing that motivation to act is a critical link between beliefs and
behaviour
- This extension increases the explanatory power of the HBM in predicting behaviour
Protection motivation theory (PMT)
- Health behaviours are motivated by a desire to protect oneself from threats, shaped
by threat and coping appraisals
- People are motivated to protect themselves from health threats based on how they
appraise the threat and their ability to cope with it
- Protection motivation: the intention to adopt a health behaviour in response to
perceived threat
- Threat appraisal:
o Perceived susceptibility: how likely one thinks they are to get the illness
o Perceived severity: how serious one believes the illness or consequences
would be
- Coping appraisal:
o Response efficacy (action-outcome efficacy): belief that the recommended
behaviour will reduce the threat
o Self-efficacy: belief in one’s own ability to perform the behaviour successfully
- Adaptive responses reduce risk (wearing sunscreen) → if people belief the threat is
real and they can deal with it effectively, they take action
- Maladaptive responses avoid or deny the problem (ignoring skin cancer risks) → if
they doubt the threat or their ability to cope, they may deny or avoid it
- Fear-based motivations, risk perception
Theory of planned behaviour (TPB)
- Behavioural intentions predict actual behaviour, moderated by perceived control
Lieke Brekelmans
Artikel 1: The role of conspiracy beliefs for COVID-19 health responses
COVID-19 conspiracy theories include ideas that the virus is a hoax, was created deliberately,
or is being used for political control.
Health-protective behaviours
- Actions taken to protect oneself or others form illness
- Mask wearing
- Social distancing
- Vaccination
Health-endangering behaviours
- Actions that increase the risk of spreading or contracting COVID-19
- Rejecting vaccines
- Refusing to follow health guidelines
Conspiracy beliefs were negatively related to health-protective behaviours.
Positive relationship with health-endangering behaviours.
Beliefs affected intentions and actual behaviours
- The more someone believed in conspiracy theories, the lower their intention to
vaccinate and the higher their likelihood to engage in risky behaviour.
Motivated reasoning
- The tendency to fit new information into existing beliefs and desires, rather than
objectively assessing evidence
- People believe in conspiracies because it helps them maintain existing worldviews or
reduce anxiety in uncertain times
Health belief model (HBM)
- Suggests people take health actions if they:
o Feel susceptible to a disease
o Believe it would have severe consequences
o Think actions will reduce risk
o Face new barriers to actions
- Conspiracy beliefs can undermine all four elements, making people feel less
vulnerable or sceptical about preventive actions
Information deficit model
- Assumes that misinformation or lack of knowledge leads to poor decisions
, - However, the study shows that beliefs are often emotionally and ideologically
motivated, not just based on missing facts
Beliefs in conspiracy theories poses a significant barriers to effective pandemic response.
Artikel 2: Cognitive determinants of health behaviour
Health cognitions
- Thoughts and feelings people associate with health-related behaviour
Social cognition models (SCM)
- Psychological models that explain behaviour through individual cognitive processes
(perceptions, beliefs and attitudes) rather than through external structural factors
- Core assumption: behaviour is guided more by an individual’s perception of reality
than by the objective reality
- Psychological theories designed to understand how individual thought processes
influence health behaviour
Self-regulation theory
- SCMs are part of self-regulation research
- Investigates how people monitor, evaluate and alter their thoughts and behaviours to
align with personal goals
Self-regulation phases
1. Motivational phase:
a. Involves forming intentions by weighing costs and benefits of actions
2. Volitional phase:
a. Involves planning and executing actions to meet set goals
SCMs largely emphasize the motivational phase, but some incorporate volitional techniques
like implementation intentions.
Health belief model (HBM)
- One of the earliest and most widely used SCMs
- Developed to understand behaviours like screening uptake
- Core components:
1. Perceived susceptibility:
a. Belief about the likelihood of getting a disease
b. How likely am I to get cancer?
2. Perceived severity:
a. Belief about the seriousness of the disease and its consequences
b. How bad would it be if I got it?
3. Perceived benefits:
a. Belief in the efficacy of the advised behaviour to reduce risk of severity
b. Will quitting smoking actually help me?
, 4. Perceived barriers:
a. Beliefs about the costs or obstacles to performing the behaviour
b. Is it too difficult or expensive to get screening?
- Additional components:
5. Cues to action:
a. Triggers (internal of external) that activate readiness to act
b. Media campaigns or experiencing symptoms
6. Health motivations:
a. A stable trait indicating a person’s general concern and motivation to maintain
health
A person is more likely to perform a health behaviour if they:
1. Feel susceptible to a serious condition
2. Believe the action is beneficial
3. Believe benefits outweigh the barriers
4. Encounter a cue to act
Susceptibility and barriers are the strongest predictors across behaviours.
Perceived susceptibility and barriers completely mediated the effect of social class on
cervical screening uptake.
Criticism om HBM
- The original model omits some important predictors of behaviour, such as self-
efficacy
Extended health belief model
- Other model that adds:
1. Self-efficacy:
a. Confidence in one’s ability to perform a behaviour
b. The belief in one’s capacity to take actions
, 2. Intention:
a. Recognizing that motivation to act is a critical link between beliefs and
behaviour
- This extension increases the explanatory power of the HBM in predicting behaviour
Protection motivation theory (PMT)
- Health behaviours are motivated by a desire to protect oneself from threats, shaped
by threat and coping appraisals
- People are motivated to protect themselves from health threats based on how they
appraise the threat and their ability to cope with it
- Protection motivation: the intention to adopt a health behaviour in response to
perceived threat
- Threat appraisal:
o Perceived susceptibility: how likely one thinks they are to get the illness
o Perceived severity: how serious one believes the illness or consequences
would be
- Coping appraisal:
o Response efficacy (action-outcome efficacy): belief that the recommended
behaviour will reduce the threat
o Self-efficacy: belief in one’s own ability to perform the behaviour successfully
- Adaptive responses reduce risk (wearing sunscreen) → if people belief the threat is
real and they can deal with it effectively, they take action
- Maladaptive responses avoid or deny the problem (ignoring skin cancer risks) → if
they doubt the threat or their ability to cope, they may deny or avoid it
- Fear-based motivations, risk perception
Theory of planned behaviour (TPB)
- Behavioural intentions predict actual behaviour, moderated by perceived control
