Self-Selection in Responding to a Health Risk Appraisal: Are We Preaching to the Choir.

摘要

Although the health risk appraisal (HRA) has been widely adopted as a procedure to improve health behaviors, there is only limited empirical evidence that these quantitative risk messages have any effect. The level of participation of high risk individuals is also unclear. The objectives of the present study were (a) to examine behavioral and sociodemographic factors associated with voluntary response to an HRA, and (b) to assess the effect of HRA feedback on subsequent preventive health behaviors and risk taking behaviors. An analysis of the factors associated with responding to the HRA revealed that respondents were older, better educated, and higher health status, smoked less, consumed less alcohol, and used seat belts more than non-respondents. Separate analyses of HRA respondents and matched controls indicated that HRA participation had no significant effect on subsequent preventive health behaviors or risk taking behaviors. Among individuals who tend to engage in high risk behaviors, denial may represent an effective strategy to underestimate risk and, thereby, mitigate against seeking objective feedback to the contrary. Younger and less educated individuals may also be more likely to discount the adverse effects of high risk health behaviors as just another menace of daily life. Given the limitations in the participation of high risk individuals and the lack of empirical support for its effectiveness, the potential of the HRA as an effective cue to action remains uncertain. (KT)