Communicating to enhance trust and manage risk perceptions during cancer cluster investigations: an exploratory study of information sources and formats

Cancer is a dreaded disease. When suspected cancer clusters are reported, they garner considerable public attention. Communicating cancer risks transparently without triggering undue alarm during cluster investigations is a significant undertaking for investigators. A failure to manage public anxiety can lead to an erosion of trust in government officials. This exploratory research aimed to examine the effects of information about a cancer cluster investigation–that varied by information source and format–on perceptions of cancer risk and information trustworthiness. We also explored the impact of information with different risk framing on cancer risk perceptions. Lastly, we examined these relationships across various psychosocial and demographic factors. We recruited 172 Canadian adults to participate in an online survey and experiment. In the experiment (2x4 factorial design), participants were randomly assigned to view one of eight vignettes about a cancer cluster in a fictional community (general risk framing). Vignettes differed by information source (government, news) and format (contextual information, personal stories, both, neither). Participants reported cancer concern and information trustworthiness. We also measured concern after presenting all participants with a hypothetical scenario about a cancer cluster in their own neighbourhood (personal risk framing), and again after providing them with reassuring information about the cluster (personal and reassuring risk framing). Participants viewing the government-authored vignettes and the vignettes containing contextual information had higher odds of perceiving the information as trustworthy compared to news-authored vignettes (OR 2.08, 95%CI 1.13–3.91) and vignettes containing neither format (OR 2.37, 95%CI 0.99–5.83), respectively. Of the eight vignettes, those authored by a government-source and containing contextual information elicited concern about cancer most frequently during the experiment (general risk framing). After providing reassuring information to participants during the hypothetical scenario (personal and reassuring risk framing), news-authored vignettes containing personal stories elicited the most frequent reports of concern. Associations appeared to vary by education. Results suggest government officials should provide citizens with information that is reassuring and contains contextual details to alleviate concerns and enhance trust during cancer cluster investigations. These findings, with follow-up research, could have implications for health departments responding to community concerns about cancer.