Fuzzy-Trace Theory, Risk Communication, and Product Labeling in Sexually Transmitted Diseases. V. F. Reyna and M. B. Adam, University of Arizona College of Medicine
The ability of health professionals to accurately convey risk depends on their understanding of that risk. Fuzzy-trace theory predicts distortions in risk perception among health professionals, including misunderstanding of CDC and FDA statements about condoms’ effectiveness in reducing sexually transmitted disease (STD). According to theory, mental representations of risk are qualitative (gist-based) rather than quantitative, even among health professionals. Professionals’ risk estimates are likely to be imprecise and based on the gist of categories, producing risk underestimation associated with atypical category members (e.g., human papillomavirus, HPV). 95 health professionals (pediatricians and internal medicine physicians whose practices include sexually active youth; public health graduate students and faculty) estimated the risks of a teenager contracting STDs, the relative risk of acquiring an STD for two teenagers (one with 12 partners and one with a partner who had 12 partners), gender differences, re-infection rates, and interpreted CDC consensus statements and FDA package labeling about condoms’ effectiveness. Risk estimates from physicians and public health professionals did not differ, although interpretations of condom effectiveness did. Professionals underestimated STD risk (especially of HPV), re-infection, and gender differences, but overestimated condoms’ effectiveness for psychologically atypical but prevalent diseases (such as HPV). Although CDC and FDA statements concerning risk reduction apply primarily to fluid-borne illness, risk estimates revealed inappropriate generalization to skin-to-skin transmission, as in HPV. Implications of gist representations for risk communication in product labeling and government guidelines are discussed.
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