Both physicians and public health specialists can learn valuable
lessons about communicating cancer risks from the experiences
of those engaged in environmental risk communications, said Frank
Baker, phd, a senior official of the American Cancer Society (ACS).
"An emergent theme from environmental risk communications
is the importance of two-way communications, which has important
implications for health risk communications as well," said
Dr. Baker, who heads the ACS programs in behavioral and psychosocial
research. He spoke at the ACS' National Conference on Cancer Prevention
and Early Detection, sponsored, in part, by the Centers for Disease
Control and Prevention.
The two areas of risk communications, environment and health,
have separate research literature that overlap in certain areas,
particularly occupational health and safety. Yet, Dr. Baker said,
they yield somewhat different perspectives on how to communicate
with the public.
The Importance of a Clear Message
One important message from the environmental field is that the
public "doesn't necessarily accept comparisons of voluntary
and involuntary risks," he said. And a person's cognitive
framework plays a major role in how they internalize risk messages.
"Psychologists have found that we live in a world of our
own perceptions and that we perceive things as hazardous depending
on these concepts," Dr. Baker noted. "People are influenced
by these cognitive limitations and these judgmental rules, and
we need to be aware of that as we structure our communications."
Whether planning an antismoking public service campaign or trying
to persuade a two-pack-a-day cigarette addict to kick the habit,
one needs to tailor the message to the knowledge level, concerns,
age, and communication-processing capabilities of the message's
target. "This is important in patient communications,"
One Style Is Not Enough
He described research he conducted at Johns Hopkins University
prior to joining ACS, during which he examined the ways the physicians
communicate risk-benefit information to people who are potential
bone marrow recipients. Rather than tailoring the information,
Dr. Baker said, the physicians tended to resort to a "one-size-fits-all
mentality," which reduced the effectiveness of their communication
"You need to recognize that people have different abilities
to process information, and certainly in anxiety provoking situations,"
Dr. Baker said. This holds also for patients' willingness and
abilities to pay attention and focus on the words and message
aimed at them. He quoted a friend who studies doctor-patient communications
as saying: "Patients hear half of what the physician says,
and then remember half of that."
Health communicators often rely on fear to convey their message,
but fear alone is not enough, Dr. Baker said. He showed a familiar
poster, one with a healthy lung on the left and a dirty, damaged
smoker's lung next to it. "Here we certainly have fear arousal,
but it doesn't tell you what you can do about it," he said.
Good occupational health communications, however, leave little
to the imagination or for misinterpretation, he said, because
they not only emphasize risk but "what you can do about it."