The structure, role and influence of risk perception within cardiovascular preventative health behaviour

Abstract

Evidence regarding the mechanism of risk perception construction and the relationship between causal risk beliefs and risk factor standing in influencing perceived cardiovascular risk remains inconclusive. Furthermore, the ability of perceived cardiovascular risk to elicit intentions to undertake intentional preventative behaviour remains unclear
Six studies draw on the Common-Sense Model of Self-Regulation and the Extended Model of Goal-Directed Behaviour (EMGB) to evaluate the role, influence and utility of cardiovascular risk perception. A systematic review evaluated the extent, sub-group differences and predictors of risk perception bias. Following two pilot studies, cross-sectional research was carried out evaluating the perceived importance of 20 medical and psychosocial causal beliefs. A subsequent study measured respondent risk factor standing against the same risks, evaluating their impact on perceived risk using the TRIRISK measure. The presence of a relationship between causal beliefs and risk exposure was also explored. A final study evaluated the influence of risk perception on intentional preventative behaviour in comparison to alternative predictors drawn from the EMBG.
The results of the systematic review reinforced the importance of measure consistency and highlighted the dominance of unrealistic optimism particularly within lower social economic status sub-groups. With notable exceptions, causal risk beliefs were found to be generally in-line with their epidemiologically derived values. However, they were found to play a limited role in determining perceived risk and are not used extensively by individuals in conjunction with risk factor standing to calculate perceived risk. Finally, risk perception was found to be a surprisingly ineffective predictor of behavioural intentions. Conversely, anticipated emotions in particular anticipated regret was found to be a highly effective.
In conclusion, the sole use of risk perception as a central tenant in preventative screening for cardiovascular disease requires revisiting. Anticipated regret represents a powerful additional interventional asset capable of improving preventative behaviour intentions.

Date of Award	1 Apr 2020
Original language	English
Awarding Institution	King's College London
Supervisor	John Weinman (Supervisor) & Myfanwy Morgan (Supervisor)