Risk perception and communication in vaccination decisions: A fuzzy-trace theory approach

doi:10.1016/j.vaccine.2011.11.070

Vaccine

Volume 30, Issue 25, 28 May 2012, Pages 3790-3797

https://doi.org/10.1016/j.vaccine.2011.11.070 Get rights and content

Abstract

The tenets of fuzzy-trace theory, along with prior research on risk perception and risk communication, are used to develop a process model of vaccination decisions in the era of Web 2.0. The theory characterizes these decisions in terms of background knowledge, dual mental representations (verbatim and gist), retrieval of values, and application of values to representations in context. Lack of knowledge interferes with the ability to extract the essential meaning, or gist, of vaccination messages. Prevention decisions have, by definition, a status quo option of “feeling okay.” Psychological evidence from other prevention decisions, such as cancer screening, indicates that many people initially mentally represent their decision options in terms of simple, categorical gist: a choice between (a) a feeling-okay option (e.g., the unvaccinated status quo) versus (b) taking up preventive behavior that can have two potential categorical outcomes: feeling okay or not feeling okay. Hence, applying the same theoretical rules as used to explain framing effects and the Allais paradox, the decision to get a flu shot, for example, boils down to feeling okay (not sick) versus feeling okay (not sick) or not feeling okay (sick, side effects, or death). Because feeling okay is superior to not feeling okay (a retrieved value), this impoverished gist supports choosing not to have the flu vaccine. Anti-vaccination sources provide more coherent accounts of the gist of vaccination than official sources, filling a need to understand rare adverse outcomes.

Highlights

► Based on fuzzy-trace theory, a new psychological model of vaccination decisions is introduced. ► Effects of background knowledge, dual mental representations (verbatim and gist), retrieval of values, and application of values are predicted. ► The model explains how anti-vaccination messages proliferate in Web 2.0 due to meaning threats and plausibility of anti-vaccination beliefs. ► Anti-vaccination sources provide more coherent narratives of the gist of vaccination, filling a need to understand rare adverse outcomes.

Section snippets

Background: fuzzy-trace theory

Although it is impossible to review all of the evidence that underpins the assumptions of fuzzy-trace theory, it is important to note that any viable theory in science should be based on sound empirical evidence. Moreover, it must accommodate all of the relevant evidence, including that generated from independent laboratories. For example, fuzzy-trace theory retains features of schema theory that are useful, but jettisons those that led to widespread criticism (and lack of empirical support) in

A process model of vaccination decisions

As the previous discussion suggests, being informed about vaccination decisions involves more than having information. According to fuzzy-trace theory, there are four aspects of decision making: knowledge (having background information or experience needed to understand the gist of options), representations (especially appreciating the meaning of key facts—the gist—of options), retrieval of values (recognizing the relevance of key values or knowledge in context), and processing (understanding

Susceptibility to anti-vaccination messages: the search for meaning

Although many of the gist representations and values discussed in the prior section support not getting vaccinated, they are not adamantly anti-vaccine [43]. Strident anti-vaccine messages are attempts to predict or explain adverse outcomes, and to link them to vaccinations. As the fastest growing source of health information, the internet has enormous potential to spread such messages [44]. The internet and social media can amplify the perceived frequency of adverse events as rare events can

Implications for public health communications

A major implication of this approach is that anti-vaccination messages connect rare and unexplained diseases such as MS or autism to vaccinations and thereby exploit a human bias towards identifying something as meaningful signal or pattern rather than random noise. The psychological processes of forming gist representations (Fig. 2), and combining them with retrieved social and moral values to make decisions (Table 1), apply broadly. However, social media in the age of Web 2.0 amplify these

Summary

An important implication of fuzzy-trace theory for vaccination decisions is that meaning is at the core of such decisions—and is heavily dependent on knowledge, experience, and prior beliefs. The meaning of vaccination decisions can be described in terms of simple categorical gists, such as a choice between feeling okay (not sick) versus taking a chance by vaccinating and either feeling okay (not sick) or not feeling okay (sick, side effects or death). Prevention decisions, by definition,

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Risk perception and communication in vaccination decisions: A fuzzy-trace theory approach

Abstract

Highlights

Section snippets

Background: fuzzy-trace theory

A process model of vaccination decisions

Susceptibility to anti-vaccination messages: the search for meaning

Implications for public health communications

Summary

Learning and Individual Differences

Developmental Review

Learning and Individual Differences

Developmental Review

Vaccine

Trends in Cognitive Sciences

Developmental Review

Developmental Review

Organizational Behavior and Human Decision Processes

Behavioural Research and Therapy

Journal of Verbal Learning and Verbal Behavior

Vaccine

Meta-analysis of the relationship between risk perception and health behavior: the example of vaccination

Health Psychology

Risky choice framing: task versions and a comparison of prospect-theory and fuzzy-trace theory

Journal of Behavioral Decision Making

Understanding the role of numeracy in health: proposed theoretical framework and practical insights

Health Education & Behavior

A theory of medical decision making and health: fuzzy-trace theory

Medical Decision Making

Shaping perceptions to motivate healthy behavior: the role of message framing

Psychological Bulletin

Diffusion of innovations and network segmentation: the part played by people in promoting health

Sexually Transmitted Diseases

The science of false memory

A perspective on judgment and choice: mapping bounded rationality

American Psychologist

Two is not always better than one: a critical evaluation of two-system theories

Perspectives on Psychological Science

How numeracy influences risk comprehension and medical decision making

Psychological Bulletin

Predicting the future with social media

Is memory schematic?

Psychological Bulletin

Risk and rationality in adolescent decision making: implications for theory, practice, and public policy

Psychological Science in the Public Interest

Physician decision-making and cardiac risk: effects of knowledge, risk perception, risk tolerance, and fuzzy processing

Journal of Experimental Psychology: Applied

Neurobiological and memory models of risky decision making in adolescents versus young adults

Journal of Experimental Psychology: Learning, Memory, and Cognition

Fuzzy-trace theory, risk communication, and product labeling in sexually transmitted diseases

Risk Analysis

How people make decisions that involve risk. A dual-processes approach

Current Directions in Psychological Science

Semantic coherence and fallacies in estimating joint probabilities

Journal of Behavioral Decision Making

Integration of the cognitive and psychodynamic unconscious

American Psychologist