Linking cognitive and affective heuristic cues to interpersonal risk perceptions and behavior

Abstract

People often use cognitive and affective heuristics when judging the likelihood of a health outcome and making health decisions. However, little research has examined how heuristics shape risk perceptions and behavior among people who make decisions on behalf of another person. We examined associations between heuristic cues and caregivers’ perceptions of their child's asthma risk, the frequency of caregivers’ asthma management behaviors, and child health outcomes. We used Ipsos KnowledgePanel to recruit 814 U.S. adult caregivers of children with asthma of the age <18 years. Participants completed a survey at baseline (T1) and 3 months later (T2). Caregivers who, at T1, reported greater negative affect about their child's asthma (affect heuristic cue), greater ease of imagining their child experiencing asthma symptoms (availability heuristic cue), and greater perceived similarity between their child and a child who has ever experienced asthma symptoms (representativeness heuristic cue) reported statistically significantly (p < 0.05) higher interpersonal perceived risk of their child having an exacerbation or uncontrolled asthma at T1. They also indicated at T2 that their child had poorer asthma control and more frequent exacerbations. Greater T1 negative affect was associated with more frequent T2 actions to reduce inflammation, manage triggers, and manage symptoms, and with poorer T2 child health outcomes. Heuristic cues are likely important for interpersonal—not just personal—risk perceptions. However, the interrelationship between caregivers’ ratings of heuristic cues (in particular, negative affect) and risk judgments may signify a struggle with managing their child's asthma and need for extra support from health care providers or systems.

Exploring Caregiver Interest in and Preferences for Interventions for Children With Risk of Asthma Exacerbation: Web-Based Survey

“…We aimed to recruit 801 caregivers with complete data at T1. We based our recruitment goal on the sample size needed to test a priori hypotheses related to caregivers’ beliefs about their children’s risk of having an asthma exacerbation [ 23 ].…”

“…We edited the items to improve clarity and to ensure that the items assessing shortness of breath and albuterol use shared the same response options. Consistent with recent research [ 23 , 40 ], we summed the 4 items assessing symptoms and impairment as a measure of asthma control. We labeled the responses to the fifth item as subjective control.…”