It seems obvious that the goal of health behaviors is to reduce health risks, and risk perceptions are at the core of most theories of health behavior. Yet, in empirical studies, the effects of risk perceptions on behavior often appear weak or nonexistent. Some investigators have even suggested that risk perceptions are irrelevant and should have no part in prevention messages.
However, the discrepancy between research and theory is probably not as great as it seems. There are serious design, measurement, and analysis flaws in many of these studies that might explain the findings. A comprehensive, critical review of this literature is badly needed to determine how strong the links between risk perceptions and risk behavior really are.
The review planned will try to answer the following questions, or show us how far we have come toward reaching answers:
- Is recognition of risk a potent motivator of healthy behavior? Can we expect to change behavior by improving risk information?
- Are risk perceptions more important for some risk behaviors than others (e.g., smoking vs. alcohol; preventive behaviors vs. screening behaviors)?
- Are risk perceptions more influential at some stages in the developmental trajectory of risk behaviors than others (e.g., experimentation, maintenance, escalation, cessation)?
- Are certain ways of assessing risk perceptions more effective in predicting behavior than others?
- How can we change risk perceptions and are they more malleable at some stages, ages, or for some health problems than others?
The review can not be a simple-minded counting of pro and con articles. It will have to take into account the appropriateness of research designs and analyses; measurement issues (including potential lack of variance in survey research and weak interventions in experimental research); potential confounding variables (such as self-efficacy); type of behavior (prevention, screening); nature of the threat (imminence, perceived controllability, etc.); and other issues.
To date, one review has been completed: A Meta-Analysis of the Relationship between Risk Perception and Health Behavior: The example of vaccination (2005) (PDF).