Heather Orom|Elizabeth Schofield|Marc T. Kiviniemi|Erika A. Waters|Caitlin Biddle|Xuewei Chen|Yuelin Li|Kimberly A. Kaphingst|Jennifer L. Hay
Low Health Literacy and Health Information Avoidance but Not Satisficing Help Explain “Don’t Know” Responses to Questions Assessing Perceived Risk
University at Buffalo, State University of New York|Memorial Sloan Kettering Cancer Center|Washington University in St. Louis|University of Utah|University at Buffalo, State University of New York|Memorial Sloan Kettering Cancer Center|Washington University in St. Louis|University of Utah|University at Buffalo, State University of New York|Memorial Sloan Kettering Cancer Center|Washington University in St. Louis|University of Utah|University at Buffalo, State University of New York|Memorial Sloan Kettering Cancer Center|Washington University in St. Louis|University of Utah|University at Buffalo, State University of New York|Memorial Sloan Kettering Cancer Center|Washington University in St. Louis|University of Utah|University at Buffalo, State University of New York|Memorial Sloan Kettering Cancer Center|Washington University in St. Louis|University of Utah|University at Buffalo, State University of New York|Memorial Sloan Kettering Cancer Center|Washington University in St. Louis|University of Utah|University at Buffalo, State University of New York|Memorial Sloan Kettering Cancer Center|Washington University in St. Louis|University of Utah|University at Buffalo, State University of New York|Memorial Sloan Kettering Cancer Center|Washington University in St. Louis|University of Utah
background people say dont know dk disease risk less likely engage protective behavior purpose study examined possible mechanisms underlying knowing ones risk common diseases methods participants nationally representative sample 1005 members standing probabilitybased survey panel answered questions comparative absolute perceived risk diabetes colon cancer health literacy risk factor knowledge health information avoidance beliefs illness unpredictability survey satisficing composite assessment following survey instructions nondifferentiation responses haphazard responding speeding primary outcomes whether person selected dk asked absolute comparative risk perception questions diabetes colon cancer base structural equation modeling path models pathways information avoidance health literacyknowledge dk responding dk outcome compared models also included pathways satisficing unpredictability beliefs results base models contained significant indirect effects health literacy odds ratios ors 094 097 p lt 002 avoidance ors 105 115 p lt 001 dk responding risk factor knowledge direct effect avoidance ors 121 128 p lt 002 adding direct effect satisficing models resulted poor fit outcomes residual mean square error estimates gt017 weighted root mean square residuals gt32 comparative fit index lt047 tuckerlewis index lt049 indicating satisficing associated dk responding unpredictability associated knowing ones diabetes risk 101 p lt 001 limitations data crosssectional therefore directionality pathways cannot assumed conclusions dk responders may need health information needs delivered differently interventions might include targeting messages lower health literacy audiences disrupting defensive avoidance threatening health information