Lipkus Isaac M, Klein William M P
Duke University Medical Center, Durham, North Carolina 27701, USA.
J Health Commun. 2006 Jun;11(4):391-407. doi: 10.1080/10810730600671870.
People typically believe their health risks are lower than those of others (i.e., optimistic bias). We sought to increase perceptions of colorectal cancer (CRC) risk among adults aged 50-75 who were nonadherent to fecal occult screening (FOBT). 160 participants were randomized to receive information about the following: (1) general CRC risk factors (control), (2) general and tailored CRC risk factor feedback (absolute risk group), or (3) absolute CRC risk factor feedback plus CRC feedback as to how their total number of risk factors compared with that of others (absolute plus comparative risk group). Primary outcomes were perceived absolute and comparative risks, attitudinal ambivalence toward FOBT, and screening intentions; the secondary outcome was return of a completed FOBT. Participants who were told that they had more than the average number of risk factors believed their comparative CRC risk was higher than that of controls and of participants informed that they did not have more than the average number of risk factors. Perceived absolute risk did not vary by group. Participants who received social comparison risk factor feedback expressed greater intentions to screen via a FOBT than participants who received absolute risk feedback and controls; they also expressed less ambivalence about FOBT screening than controls. Although not statistically significant, participants informed they were at lower comparative risk had the highest proportion of completing an FOBT than any other group. These results suggest that providing social comparison CRC risk factor feedback can effectively reduce optimistic comparative risk perceptions. Contrary to findings of models of health behavior change, being informed that one does not have more than the average number of CRC risk factors, while resulting in lower evaluations of perceived comparative risk, did not result in higher ambivalence toward and lower intentions to screen using FOBT or the lowest rate of screening.
人们通常认为自己面临的健康风险低于其他人（即乐观偏差）。我们试图提高50 - 75岁未坚持粪便潜血筛查（FOBT）的成年人对结直肠癌（CRC）风险的认知。160名参与者被随机分组以接收以下信息：（1）一般的CRC风险因素（对照组），（2）一般及量身定制的CRC风险因素反馈（绝对风险组），或（3）绝对CRC风险因素反馈加上关于其风险因素总数与他人相比情况的CRC反馈（绝对加比较风险组）。主要结果是感知到的绝对和比较风险、对FOBT的态度矛盾以及筛查意愿；次要结果是完成的FOBT的返还情况。被告知自己的风险因素数量超过平均水平的参与者认为他们的比较CRC风险高于对照组以及被告知自己的风险因素数量未超过平均水平的参与者。感知到的绝对风险在各小组之间没有差异。与接受绝对风险反馈的参与者和对照组相比，接受社会比较风险因素反馈的参与者表示更有意愿通过FOBT进行筛查；他们对FOBT筛查的矛盾态度也比对照组更少。尽管没有统计学意义，但被告知自己处于较低比较风险的参与者完成FOBT的比例高于其他任何组。这些结果表明，提供社会比较CRC风险因素反馈可以有效降低乐观的比较风险认知。与健康行为改变模型的研究结果相反，被告知自己的CRC风险因素数量未超过平均水平，虽然导致对感知到的比较风险的评价较低，但并没有导致对使用FOBT进行筛查的更高矛盾态度和更低意愿，也没有导致最低的筛查率。
