Every day in the United States, on average, three communities reach a sufficient state of concern to contact their state health department for the investigation of a suspected cancer cluste, ran unusual and unexplained increase in the occurrence of cancer in space and time. State health departments investigate about a third of these cases in one way or another, but find that very few (about 1%) present suspect cancer rates. However, these cases of community concern and health department response present an effective circumstance in which to investigate risk perception, risk communication, and public participation in risk analysis. This project is the continuation and expansion of an established research effort designed to examine the social and psychological circumstances surrounding citizen-initiated cancer cluster investigations, with an emphasis on two aspects: the effects of state health department communications, and the experiences of citizens and officials in public meetings held during these cases. To meet the first goal, the project will integrate, and develop, two primary theoretical models, one central to risk perception (the Psychometric model) and one central to information processing and decision making (the Heuristic-Systematic model). Previous work in this effort has examined a series of five such cases. This expansion will use mail and phone survey methods to look at a larger and more diverse set of cluster investigations (about 50), enabling a comparison across cases. The analysis will continue the refinement of a model that describes the effects of information provided to communities in these cases, and will also evaluate the effects of the specific circumstances unique to theses cases (e.g., types of cancer, suspected causes). The analysis will also focus on the different communication techniques used by various state health departments to convey the results of their epidemiological investigations. To meet the second goal, a set of five cases will be more deeply studied with an emphasis on the public meetings that are almost always an important feature of these community experiences. That effort will make further use of mail and phone survey methods, and will also make use of extensive interviews and focus groups. Overall, the project is expected to provide a detailed examination of how information is conveyed in these cases, and how citizens make use of information to reach, or modify, their orientation toward concerns about cancer rates.
Relative to scientific interests in risk perception, one of the most interesting aspects of this investigation resides in the fact that cluster cases almost always present a circumstance in which the scientific evidence indicates little or no risk, yet that evaluation is couched in the probabilistic language of cancer epidemiology. This investigation will advance scientific understanding of how individuals react to this form of information, a problem that has been a long-standing concern in the fields of psychology, social-psychology, and risk communication. In more practical terms, this project is also designed to evaluate the methods by which this form of information is provided to communities. The analysis will illuminate the more effective means of communicating the results of epidemiological studies and as such will provide important and useful feed-back for those who are charged with that work. The project's ultimate goal is that this kind of information will be communicated more effectively and the communities involved in such cases will be better served.
