The participatory model of risk communication: Identifying gaps in risk perception of breast cancer and screening amongst lay and professional groups

Much risk communication in health has been based implicitly on a hypodermic model (McQuail, 1984) that does not take account of the complexity and diversity of communication processes in social conditions under uncertainty (Beck, 1992; Giddens, 1998). It has been suggested that a better understanding of ‘lay responses’ to risks might contribute significantly to the improvement of risk communication and management (Bennett, 1999). Several authors have advocated the participatory model of risk communication and continual dialogue with the public (Renn, 1991; Coote & Franklin, 1999). In this model, lay people are involved in the formulation of risk communication strategies and risk management. This paper aims to illustrate the potential of the model in addressing risk communication research/practice through a discussion of the process and outcomes of the second phase of the participatory action research project Informed Choice For All: communicating cancer and cancer screening risks to minority ethnic and low-income groups (Chiu, 2008).  In this phase of the project, professional and lay perspectives on breast cancer and cancer screening risks were investigated using a mixed-method of focus groups and Q-sorts.  A total of 61 individuals (10=professionals, 51= women from five ethnic communities) participated in Q-sorts. Three distinctive viewpoints emerged from Q-sorts analysis. These can be characterised as:  1) Medico-official, 2) Moderately informed, 3) Uninformed anxious and fatalistic.  Perceptual gaps between lay groups and professionals were identified. The analyses also revealed how different perceptions are structured by lay and scientific knowledge, beliefs and affects.  While there is a clear difference in risk perception between lay groups and health professionals, the pattern across ethnic groups is complex and diverse, highlighting the intersection of ethnicity with other social and cultural factors. It is argued that the methodological design of the project presents an innovative approach towards a participatory model of risk communication.