Dynamic Risk Perceptions in Times of Avian and Seasonal Influenza Epidemics: A Repeated Cross-Sectional Design

Abstract

Infectious diseases pose a serious threat to humans. Therefore, it is crucial to understand how accurately people perceive these risks. However, accuracy can be operationalized differently depending on the standard of comparison. The present study investigated accuracy in risk perceptions for three infectious diseases (avian influenza, seasonal influenza, common cold) using three different standards for accuracy: Social comparison (self vs. others’ risk perceptions), general problem level (risk perceptions for diseases with varying threat levels), and dynamic problem level (risk perceptions during epidemics/seasons vs. nonepidemic/off-season times). Four online surveys were conducted using a repeated cross-sectional design. Two surveys were conducted during epidemics/seasons of avian influenza, seasonal influenza, and common cold in 2006 (n = 387) and 2016 (n = 370) and two surveys during nonepidemic/off-season times for the three diseases in 2009 (n = 792) during a swine flu outbreak and in 2018 (n = 422) during no outbreak of zoonotic influenza. While on average participants felt less at risk than others, indicating an optimistic bias, risk perceptions matched the magnitude of risk associated with the three infectious diseases. Importantly, a significant three-way interaction indicated dynamic accuracy in risk perceptions: Participants felt more at risk for seasonal influenza and common cold during influenza and cold seasons, compared with off-season times. However, these dynamic increases were more pronounced in the perceived risk for others than for oneself (optimistic bias). The results emphasize the importance of using multiple approaches to assess accuracy of risk perception as they provided different information on how accurately people gauge their risk when facing infectious diseases.