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This study examined hospital preparedness and radiation risk perception among nurses in Iran, uniquely applying the Transtheoretical Model to identify behavioral predictors of emergency readiness.
Methods
This cross-sectional study was conducted among 152 health care workers in three teaching hospitals. Four validated tools assessed hospital preparedness, knowledge, risk perception, and stages of change. Linear regression identified predictors of behavioral progression.
Results
While the hospital equipment domain scored highest (mean 18.3/21), the education domain scored lowest (mean 2.3/4). Notably, 85.5% of nurses remained in the passive stages of change, with only moderate levels of risk perception. Cognitive (β = 0.937) and behavioral processes (β = 0.763) strongly predicted stage advancement, extending previous findings on behavioral determinants of disaster preparedness.
Conclusion
This study suggests that psychological readiness may play an important role in radiation emergency preparedness. Stimulus control and reinforcement management represent critical behavioral targets that are often overlooked in traditional training. Policymakers should consider shifting from awareness-only approaches to stage-matched, behaviorally driven interventions that address nurses’ emotional barriers and support sustained readiness.
Low insurance uptake in developing countries poses a strong obstacle to financial resilience and poverty reduction. Although behavioural biases, such as ambiguity aversion, myopia and distrust, are acknowledged as key barriers, their combined effects are not directly observed. Therefore, this study relies on regulatory and administrative proxies linked to these biases. This study goes beyond analysing these proxies separately to explore how they co-occur in shaping insurance outcomes. Using a novel crisp-set Qualitative Comparative Analysis (csQCA) on a sample of 40 developing countries across Africa, Asia, Central and Eastern Europe and the Americas, we identify multiple, equifinal configurations of regulatory and institutional conditions associated with higher insurance uptake. Our necessity analysis reveals that transparent pricing is central to regulatory environments associated with insurance uptake. In addition, product suitability and design standards, as well as deposit insurance coverage, are sufficient regulatory requirements when combined. The csQCA results show that no condition works in isolation; outcomes are associated with specific combinations of regulatory and institutional conditions. The findings indicate that interventions should be interpreted as configurational regulatory packages.
This study examined whether coronavirus disease 2019 (COVID-19) infection experience enhances preventive behaviour (i.e., hand disinfection and mask-wearing), with risk perception acting as a mediating factor. The study included participants aged ≥18 years residing in Japan, enrolled in a 30-wave cohort study conducted from January 2020 to March 2024. Using propensity score matching, 135 pairs of participants with and without infection were extracted, adjusting for dread and unknown risk perception, preventive behaviours, sociopsychological variables, and individual attributes. Comparisons of risk perception and preventive behaviour were made between groups post-infection experience, and mediation analysis was conducted to test whether risk perception mediated the effect of infection experience on preventive behaviour. Following the infection experience, participants in the infection group reported significantly higher scores for one item of unknown risk perception and a greater proportion of mask-wearing. The indirect effect of infection experience on mask-wearing, mediated by the unknown risk perception item, was significant. COVID-19 infection experience increased perceptions of unknowable exposure, which in turn promoted mask-wearing behaviour. Incorporating insights from personal infection experiences into public health messaging may enhance risk perception and promote preventive behaviour among non-infected individuals, offering a novel approach to infection control at the population level.
This study explores how loneliness affects earthquake risk perception and preparedness behaviors among older adults in Japan. Aging is often accompanied by increased vulnerability to natural disasters, and loneliness is hypothesized to compromise effective preparedness. Using the Japanese Older Adult Preparedness Model (JOAPM), which integrates the Protective Action Decision Model (PADM) and cultural context, we examine how loneliness influences both perceived earthquake risk and protective behaviors.
Methods
An online survey conducted in April 2024 gathered responses from adults aged 55 and older across 4 earthquake-prone Japanese prefectures. Measures included demographics, disaster experience, loneliness (UCLA Loneliness Scale), risk perception, and preparedness actions such as household adjustments. Regression and mediation analyses assessed the direct and indirect effects of loneliness on preparedness.
Results
Findings show that loneliness has a significant negative direct effect on disaster preparedness. However, it also slightly increases risk perception, which in turn has a positive relationship with preparedness behaviors, suggesting a modest indirect pathway. Overall, the direct negative effect of loneliness outweighs the indirect benefit.
Conclusion
The results highlight the complex role of psychosocial factors in disaster readiness, suggesting that interventions should address information dissemination, self-efficacy, and the emotional isolation experienced by older adults in high-risk areas.
Cumulative environmental harms pose pronounced challenges for human recognition, understanding, acceptance, and action. This chapter harvests insights across a wide range of disciplines to unpack the challenges involved in dealing with cumulative environmental problems. These insights point to a crucial role for well-crafted law and policy in responding to cumulative environmental problems. Analyzing cross-disciplinary insights about key challenges produces a framework of four integrated functions required for effective regulatory responses to cumulative environmental problems – the CIRCle Framework: (1) conceptualization: clearly and consistently conceptualizing the matter of concern that experiences cumulative impacts; (2) information: collecting, sharing, and analyzing information about environmental conditions, threats and benefits, rules and activities; (3) regulatory intervention: intervening to ensure cumulative impacts remain within an acceptable range; and (4) coordination among governments and stakeholders to undertake or contribute to the other functions.
The COVID-19 pandemic impacted individuals worldwide, regardless of their geographic location, religious or political beliefs, occupation, or social standing. People’s experiences were directly impacted by lockdown measures, physical distancing, masks, vaccine recommendations, or illness of self or friend or family member, as well as by how their local and national elected officials and public health leaders managed and communicated about the pandemic. As people went into lockdown, they went online and found a proliferation of information both true and false about the pandemic. The constant deluge of online information, the new and evolving outbreak, and the worldwide impact created a complex health emergency. The COVID-19 pandemic brought emergency risk communication to the forefront of every health agency in the United States, from city to county to state to federal levels of government. This chapter provides an overview of public health preparedness; explains how Crisis and Emergency Risk Communication (CERC) is different from day-to-day public health communication; summarizes the CERC framework and phase-based messaging; and outlines how risk perception impacts the way people process information about health threats. A student case study analyzes a Legionnaires’ disease outbreak using the CERC framework. Reflection questions are included at the end of the chapter.
Foodborne illnesses are costly to society and have been associated with local produce. The affordable “3-step wash” cleaning procedure was designed to reduce pathogens on produce. We estimate consumer willingness to pay (WTP) for food safety (i.e. 3-step washed), prepackage, and sales location attributes in locally grown produce (e.g., lettuce). On average, consumers are willing to pay $1.46 more for 3-step washed and $0.30 more for prepackaged lettuce. Additionally, consumers are willing to pay $0.16 more for fresh produce sold in natural stores and farmers markets compared to supermarkets, but $0.22 less for produce sold in other direct-to-consumer locations such as roadside stands. Higher WTP for the food safety attribute is associated with consumers who have greater risk aversion, less knowledge of foodborne illness, and stricter food safety cleaning and handling practices. Consumers highly concerned about foodborne risks also show higher WTP for both food safety and prepackage attributes. These findings can guide local farmers in making decisions about adopting pathogen-reduction cleaning procedures, selecting sales locations, and developing effective marketing strategies.
When faced with the challenge of forming a portfolio containing a risky and a risk-free asset, investors tend to apply the same portfolio weights independently of the volatility of the risky asset. This “percentage heuristic” can lead to different levels of portfolio risk when the same investor is presented with a more or a less risky asset. Using four experiments, we show that asking investors to choose the return distribution for their portfolio while keeping the exact portfolio weights unknown leads to greater similarity in levels of portfolio volatility (across different levels of risk of the risky asset) than asking investors to choose this distribution while additionally facing the portfolio weights. Higher consistency in risk taking is obtained both between and within test subjects.
With a novel experimental design we investigate whether risk perception, return expectations, and investment propensity are influenced by the scale of the vertical axis in charts. We explore this for two presentation formats, namely return charts and price charts, where we depict low- and high-volatility assets with distinct trends. We find that varying the scale strongly affects people’s risk perception, as a narrower scale of the vertical axis leads to significantly higher perceived riskiness of an asset even if the underlying volatility is the same. Furthermore, past returns predict future return expectations almost perfectly. In our setting perceived profitability was considered more important than perceived riskiness when making investment choices. Overall we show that adapting the scale of a chart makes it easier to recognize yearly return variations within a single security, but at the same time makes it harder to identify differences between dissimilar securities. This is something regulators should be aware of and take into account in the rules they set.
Oral traditions describing details of ancient volcanic eruptions and their effects survive throughout the inhabited world. Many such eruptions, especially those having catastrophic environmental and societal consequences, proved sufficiently memorable to form the basis of enduring oral traditions. Using global databases, we identified 2306 such eruptions from 477 inhabited locations that occurred before the start of the Common Era (CE) and are therefore likely to have been the subject of oral traditions. Of these, we selected 20 events (‘remembered’ Holocene eruptions) for which there are extant oral (-derived) traditions that demonstrate how such traditions can reveal details of past volcanism that often are undetectable by retrodictive geoscientific enquiry. We also selected 20 events (‘forgotten’ Holocene eruptions) about which no oral traditions are known and discuss the possible reasons for this. Such oral traditions, while often challenging for conventionally trained geoscientists to interpret, are valuable yet largely overlooked sources of information about the nature and effects of Holocene volcanism that can usefully complement geoscientific enquiry. In particular, we identified locations where memories of such volcanism appear ‘forgotten’ in the hope that scientists might focus their attention on revealing, identifying, and analyzing local traditions.
Disasters can cause great physical and financial damage to pet owners in developing countries. These effects lead to severe psychological side effects on individuals and families. With the tendency of families to keep pets in these countries, many challenges have arisen regarding how to manage these pets before, during, and after disasters. Therefore, mitigation, prevention, and preparedness measures for these families should be prioritized in the disaster management cycle to minimize psychological effects such as posttraumatic stress disorder (PTSD) after losing pets.
Decades of research seek to understand how people form perceptions of risk by modeling either individual-level psychological processes or broader social and organizational mechanisms. Yet, little formal theoretical work has focused on the interaction of these 2 sets of factors. In this paper, I contribute to closing this gap by modifying a psychologically rich individual model of probabilistic reasoning to account for the transmission and collective emergence of risk perceptions. Using data from 357 individuals, I present experimental evidence in support of my main building assumptions and demonstrate the empirical validity of my model. Incorporating these results into an agent-based setting, I simulate over 1.5 billion social interactions to analyze the emergence of risk perceptions within organizations under different information frictions (i.e., limits on the availability and precision of social information). My results show that by focusing on information quality (rather than availability), groups and organizations can more effectively boost the accuracy of their emergent risk perceptions. This work offers researchers a formal framework to analyze the relationship between psychological and organizational factors in shaping risk perceptions.
This chapter critically assesses the psychological stepping stones to people fully participating in revolutionary movements. The eight stepping stones are: that people become aware of an alternative ideal, feel deeply dissatisfied with their lives in the present society, see their dissatisfaction as not being their own fault, interpret the ruling regime as being responsible for their dissatisfaction, believe the ruling regime is illegitimate, conceive that it is possible to overthrow the ruling regime, have faith that the fall of the ruling regime will be followed by progress toward an ideal society, and be prepared to risk making serious personal and collective sacrifices in the cause of progress toward the ideal society. People passing through the eight stepping stones depend a great deal on psychological interpretations, and particularly on the social comparisons they make. Before the revolution, revolutionaries encourage people to make upward social comparisons – with better-off others, or themselves as they would be ideally. But after regime change, the new revolutionary government encourages people to make comparisons with people who are worse off than themselves.
As heatwaves increase and intensify worldwide, so has the research aimed at outlining strategies to protect individuals from their impact. Interventions that promote adaptive measures to heatwaves are encouraged, but evidence on how to develop such interventions is still scarce. Although the Health Belief Model is one of the leading frameworks guiding behavioral change interventions, the evidence of its use in heatwave research is limited. This rapid review aims to identify and describe the main themes and key findings in the literature regarding the use of the Health Belief Model in heatwaves research. It also highlights important research gaps and future research priorities. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 10 articles were included, with a geographic distribution as follows: United States (n = 1), Australia (n = 1), Pakistan (n = 1), and China (n = 1), as well as Malaysia (n = 2), Germany (n = 1), and Austria (n = 1). Results showed a lack of research using the Health Belief Model to study heatwaves induced by climate change. Half of the studies assessed heatwave risk perception, with the 2 most frequently used constructs being Perceived Susceptibility and Perceived Severity. The Self-efficacy construct was instead used less often. Most of the research was conducted in urban communities. This review underscores the need for further research using the Health Belief Model.
This study delves into the progression of nuclear war risk perceptions during the initial 6 months of the Ukraine war. It particularly investigated the influence of Italian media coverage changes and the affective tone of war representation. Utilizing a mixed-methods approach, two separate yet interconnected studies were conducted. The first study employed web scraping and keyword selection techniques to assess emotional language and quantify war-related content in the headlines of Italian online newspapers from March to July 2022. Results demonstrated a linear decrease in war-related news and an emotional shift, with a significant decrease in fear and an increase in joy noted between March and May. The second study examined nuclear war risk perceptions at an individual level, surveying a panel of 397 Italians at three distinct points during the same time frame. The findings revealed a similarity between the media’s affective tone and individuals’ affective risk perceptions. Analytic risk perception, in contrast, showed a linear decrease that matched the decline in war-related news volume. The study found preexisting individual differences, among women and older participants, to be significant determinants in shaping risk perception evolution. These groups exhibited higher initial risk perceptions and more resistance to change as the scenario unfolded. This research contributes to the existing body of work that underscores the media’s role in influencing risk perceptions by illuminating the relationship between media representation of the Ukraine war and individual-level affective risk perception. Furthermore, it highlights individual differences as significant moderators of risk perception change during a crisis.
The COVID-19 pandemic has exacerbated challenges for millions of students globally, leading to enrollment cliff. This study addresses the existing research gap by investigating the influence of students’ mental health and various protective factors (i.e., optimism, help-seeking behaviors, social support) on academic persistence, an indicator of student retention. We utilized the structural equation modeling approach to examine the effect of students’ mental health conditions, risk perception of COVID-19 and protective factors on academic persistence through a sample of 1,051 students from 45 states. Students’ mental health positively predicted academic persistence. Risk perception of COVID-19 was negatively associated with mental health but positively predicted academic persistence and help-seeking behaviors. Optimism fully mediated the effect of mental health on help-seeking behaviors but did not mediate the effect of risk perception on help-seeking behaviors. Social support positively predicted academic persistence. This study underscores the integral role of mental health and protective factors in supporting student retention. Universities should develop targeted programs to address students’ mental health needs and promote protective behaviors. These initiatives can enhance academic persistence, thereby aiding in the retention of students affected by this pandemic or any future global crisis.
This chapter asks how voters react to political messaging and, crucially, sometimes change their minds. It begins by reviewing experimental psychology, neuroimaging, and artificial intelligence research showing that the brain reasons in two distinct ways: Recognizing patterns (fast or Type 1 thought) and constructing logical arguments (slow or type 2 thought). It then argues that the first mode almost always dominates political thought. The paradox is that humans have evolved to feel pleasure both in confirming old patterns and in being surprised by new ones. This means that while political messaging is often repetive, humans are also susceptible to messages that feature large departures from current orthodoxies. Because of majority rule, politicians will normally prefer messages that appeal to large numbers of voters. This explains how even highly-polarized electorates can sometimes realign around new issues to restore a more centrist politics.
Research has shown that patients with somatoform disorders (SFD) have difficulty using medical reassurance (i.e. normal results from diagnostic testing) to revise concerns about being seriously ill. In this brief report, we investigated whether deficits in adequately interpreting the likelihood of a medical disease may contribute to this difficulty, and whether patients’ concerns are altered by different likelihood framings.
Methods
Patients with SFD (N = 60), patients with major depression (N = 32), and healthy volunteers (N = 37) were presented with varying likelihoods for the presence of a serious medical disease and were asked how concerned they are about it. The likelihood itself was varied, as was the format in which it was presented (i.e. negative framing focusing on the presence of a disease v. positive framing emphasizing its absence; use of natural frequencies v. percentages).
Results
Patients with SFD reported significantly more concern than depressed patients and healthy people in response to low likelihoods (i.e. 1: 100 000 to 1:10), while the groups were similarly concerned for likelihoods ⩾1:5. Across samples, the same mathematical likelihood caused significantly different levels of concern depending on how it was framed, with the lowest degree of concern for a positive framing approach and higher concern for natural frequencies (e.g. 1:100) than for percentages (e.g. 1%).
Conclusions
The results suggest a specific deficit of patients with SFD in interpreting low likelihoods for the presence of a medical disease. Positive framing approaches and the use of percentages rather than natural frequencies can lower the degree of concern.
Three theoretical traditions dominate our understanding of decision-making. The rational actor model assumes individuals are self-interested and maximize their utility subject to budget and time constraints. When outcomes depend on the decisions of others, as in the problem of common pool resources, trust and norms can avoid support sustainability. Social psychological models examine the role of values, especially altruism and self-interest, beliefs, norms, identity, emotions, empathy and trust in decision-making. The heuristics and biases literature shows that decisions are often based on mental shortcuts that deviate from the rational actor model. Our tendency towards biased uptake of new information and communicating mostly with those similar to us can lead to polarization. The three theories can be viewed as complementary: each yields important insights into decision-making.
Joan Costa-Font, London School of Economics and Political Science,Tony Hockley, London School of Economics and Political Science,Caroline Rudisill, University of South Carolina
This chapter goes over the decision to purchase health insurance (or not). The way information is presented to individuals has a significant impact on their decision to purchase insurance to protect themselves from the financial consequences of health risks. Eliminating minor inconvenience costs or simplifying the insurance selection process can influence whether or not people purchase insurance. This chapter examines the roles of adverse selection and moral hazard in insurance-related behaviour, as well as the barriers to insurance uptake for individuals ranging from affordability to unobservable quality and information/choice overload. The chapter investigates the role of various nudges in increasing health insurance uptake.