Does Iconicity in Pictographs Matter? The Influence of Iconicity and Numeracy on Information Processing,Decision Making,and Liking in an Eye‐Tracking Study

Researchers recommend the use of pictographs in medical risk communication to improve people's risk comprehension and decision making. However, it is not yet clear whether the iconicity used in pictographs to convey risk information influences individuals’ information processing and comprehension. In an eye‐tracking experiment with participants from the general population (N = 188), we examined whether specific types of pictograph icons influence the processing strategy viewers use to extract numerical information. In addition, we examined the effect of iconicity and numeracy on probability estimation, recall, and icon liking. This experiment used a 2 (iconicity: blocks vs. restroom icons) × 2 (scenario: medical vs. nonmedical) between‐subject design. Numeracy had a significant effect on information processing strategy, but we found no effect of iconicity or scenario. Results indicated that both icon types enabled high and low numerates to use their default way of processing and extracting the gist of the message from the pictorial risk communication format: high numerates counted icons, whereas low numerates used large‐area processing. There was no effect of iconicity in the probability estimation. However, people who saw restroom icons had a higher probability of correctly recalling the exact risk level. Iconicity had no effect on icon liking. Although the effects are small, our findings suggest that person‐like restroom icons in pictographs seem to have some advantages for risk communication. Specifically, in nonpersonalized prevention brochures, person‐like restroom icons may maintain reader motivation for processing the risk information.     

Individual differences in numerical representations of risk in health decision making: A fuzzy-trace theory approach

Fuzzy-trace theory predicts that decisionmakers process numerical information about risk at multiple levels in parallel: the simplest level, nominal (categorical some-none) gist, and at more fine-grained levels, involving relative comparison (ordinal less-more gist) and exact quantities (verbatim representations). However, little is known about how individual differences in these numerical representations relate to judgments and decisions, especially involving health tradeoffs and relative risks. To investigate these differences, we administered measures of categorical and ordinal gist representations of number, objective numeracy, and intelligence in two studies (Ns = 978 and 956). In both studies, categorical and ordinal gist representations of number predicted risk judgments and decisions beyond objective numeracy and intelligence. Participants with higher scores in categorical gist were more likely to choose options to avoid cancer recurrence risks; those who were higher in ordinal gist of numbers were more likely to discriminate relative risk of skin cancer; and those with higher scores in objective numeracy were more likely to choose options that were numerically superior overall in terms of relative risk of skin cancer and of genetic risks of breast cancer (e.g., lower numerical probability of cancer). Results support parallel-processing models that assume multiple representations of numerical information about risk, which vary in precision, and illustrate how individual differences in numerical representations are relevant to tradeoffs and risk comparisons in health decisions. These representations cannot be reduced to one another and explain psychological variations in risk processing that go beyond low versus high levels of objective numeracy.     

Evaluating the Perceived Efficacy of Randomized Security Measures at Airports

Both the increase in traveler numbers and the heightened threat posed by terrorism in recent years represent significant challenges to airport security measures. To ensure that a high level of security is maintained, randomized security checks have been proposed as a promising alternative to traditional security approaches. The use of randomized checks means that only a specific number of people are selected for security screening. However, the likely effects of such a change in security procedures on travelers’ security perceptions and on the deterrence of criminal activities remain unclear. Thus, the present study examines how varying the percentage of people screened during security checks influences people's security perceptions. In two online experiments, the participants were asked to imagine that they sought to smuggle an explosive dummy past an airport security check. The only information provided was the number of people screened during security checks, which was manipulated between-subjects in the first experiment and within-subjects in the second experiment. The participants then had to rate their security perception (i.e., the perceived likelihood of successfully smuggling the explosive dummy). The findings show that people perceive traditional security checks to be safer than randomized checks, irrespective of whether 90% or 30% of people are screened. Hence, if randomized security checks would indeed be implemented, it would automatically lead to a decreased perception of security. Furthermore, this decreased security perception might lead to an actual reduction in security, as the deterrence of criminal activities could also be reduced.     

Does schooling protect sexual health? The association between three measures of education and STIs among adolescents in Malawi

While multiple studies have documented shifting educational gradients in HIV prevalence, less attention has been given to the effect of school participation and academic skills on infection during adolescence. Using the Malawi Schooling and Adolescent Study, a longitudinal survey that followed 2,649 young people aged 14–17 at baseline from 2007 to 2013, we estimate the effect of three education variables: school enrolment, grade attainment, and academic skills—numeracy and Chichewa literacy—on herpes simplex virus type 2 (HSV-2) and HIV incidence using interval-censored survival analysis. We find that grade attainment is significantly associated with lower rates of both HSV-2 and HIV among girls, and is negatively associated with HSV-2 but not HIV among boys. School enrolment and academic skills are not significantly associated with sexually transmitted infections (STIs) for boys or girls in our final models. Efforts to encourage school progression in high-prevalence settings in sub-Saharan Africa could well reduce, or at least postpone, acquisition of STIs.     

Development of a Health Literacy Assessment for Young Adult College Students: A Pilot Study

Abstract

Objective: The purpose of this study was to develop a comprehensive health literacy assessment tool for young adult college students. Participants: Participants were 144 undergraduate students. Methods: Two hundred and twenty-nine questions were developed, which were based on concepts identified by the US Department of Health and Human Services, the World Health Organization, and health communication scholars. Four health education experts reviewed this pool of items and helped select 87 questions for testing. Students completed an online assessment consisting of these 87 questions in June and October of 2012. Item response theory and goodness-of-fit values were used to help eliminate nonperforming questions. Results: Fifty-one questions were selected based on good item response theory discrimination parameter values. Conclusions: The instrument has 51 questions that look promising for measuring health literacy in college students, but needs additional testing with a larger student population to see how these questions continue to perform.     

Helping Individuals to Understand Synergistic Risks: An Assessment of Message Contents Depicting Mechanistic and Probabilistic Concepts

Accumulating evidence shows that certain hazard combinations interact to present synergistic risks. However, little is known about the most effective ways of helping individuals to understand this complex risk concept. More specifically, there is an absence of empirical research that has assessed the relative efficacy of messages that explain either the causal mechanism and/or the probabilistic components of synergistic risks. In an experiment designed to address this issue, we presented participants with messages concerning the synergistic risk of developing esophageal cancer for individuals who consume both tobacco and alcohol. Relative to a control group, we compared the extent to which messages featuring content detailing the underlying biological mechanism, the probabilistic risk, or both improved understanding of the synergistic risk. Our results showed that messages containing details of both the mechanism and probabilistic information were most effective at enabling individuals to understand that the alcohol‐tobacco combination presents a synergistic risk. In addition, large improvements in the accuracy of cancer frequency estimates were observed amongst individuals who received probabilistic information, and the highest relative increase in professed willingness to adopt precautionary behaviors was observed amongst individuals who received the mechanism information only. Importantly, these findings could be utilized in the development of a general model for the communication of synergistic risks. Furthermore, in contrast to previous findings, our study demonstrates that risk messages can be both effective and efficient in helping individuals to acquire a greater understanding of synergistic risks. Acquiring such knowledge could lead to significant improvements in risk‐related decisions concerning combined hazards.     

History Does Its Bit

Numeracy is as essential to becoming an active and thoughtful citizen as literacy. Although the concept of numeracy is complex and robust, there are four areas in which teachers can fairly easily begin to incorporate it into social studies curriculum and instruction. The areas include the students' ability to understand raw numeric data in context, to understand percentages in context, to understand the meaning of average, and to interpret and question graphs and charts. The author shares ways to cultivate numeracy in the social studies education classroom related to each of these four basic aspects of numeracy.     

Using a Familiar Risk Comparison Within a Risk Ladder to Improve Risk Understanding by Low Numerates: A Study of Visual Attention

Previous experimental research provides evidence that a familiar risk comparison within a risk ladder is understood by low‐ and high‐numerate individuals. It especially helps low numerates to better evaluate risk. In the present study, an eye tracker was used to capture individuals’ visual attention to a familiar risk comparison, such as the risk associated with smoking. Two parameters of information processing—efficiency and level—were derived from visual attention. A random sample of participants from the general population (N= 68) interpreted a given risk level with the help of the risk ladder. Numeracy was negatively correlated with overall visual attention on the risk ladder (r_s=?0.28, p= 0.01), indicating that the lower the numeracy, the more the time spent looking at the whole risk ladder. Numeracy was positively correlated with the efficiency of processing relevant frequency (r_s= 0.34, p < 0.001) and relevant textual information (r_s= 0.34, p < 0.001), but not with the efficiency of processing relevant comparative information and numerical information. There was a significant negative correlation between numeracy and the level of processing of relevant comparative risk information (r_s=?0.21, p < 0.01), indicating that low numerates processed the comparative risk information more deeply than the high numerates. There was no correlation between numeracy and perceived risk. These results add to previous experimental research, indicating that the smoking risk comparison was crucial for low numerates to evaluate and understand risk. Furthermore, the eye‐tracker method is promising for studying information processing and improving risk communication formats.     

The Use of Narrative Evidence and Explicit Likelihood by Decisionmakers Varying in Numeracy

Decisionmakers are often presented with explicit likelihood assessments (e.g., there is a 10% chance that an attack will occur over the next three months) and supporting narrative evidence in forecasting and risk communication domains. Decisionmakers are thought to rely on both numerical and narrative information to the extent that they perceive the information to be diagnostic, accurate, and trustworthy. In two studies, we explored how lay decisionmakers varying in numeracy evaluated and used likelihood assessments and narrative evidence in forecasts. Overall, the less numerate reported higher risk and likelihood perceptions. In simple probabilistic forecasts without narrative evidence, decisionmakers at all levels of numeracy were able to use the stated likelihood information, although risk perceptions of the less numerate were more affected by likelihood format. When a forecast includes narrative evidence, decisionmakers were better able to use stated likelihood in a percentage as compared to frequency or verbal formats. The more numerate used stated likelihood more in their evaluations whereas the less numerate focused more on the narrative evidence. These results have important implications for risk analysts and forecasters who need to report the results of their analyses to decisionmakers. Decisionmakers varying in numerical ability may evaluate forecasts in different ways depending on the types of information they find easiest to evaluate.