By Lulu Rodriguez and Suman Lee

Abstract

This study examined what variables – technical/rational or normative/value – predict public worry and dread about bioterrorist attacks. Data from a national sample indicate that the technical variable of media attention and the normative variable of perceived readiness of the government to counter threats predicted level of worry. The normative variables of trust in universities and advocacy groups, trust in interpersonal sources, alienation from government, and government readiness to defend the country against attacks predicted level of dread. The results point to the need to provide the public with information, through the most effective channels, to maintain a sense of trust in the government’s and individuals’ abilities to provide protection in the event of attack.

Introduction

When the World Trade Center collapsed in the aftermath of the September 11, 2001 attacks, experts, and the public generally agreed that terrorism would be a facet of modern life in the foreseeable future, and that the likelihood of nuclear, chemical, and biological weapons being deployed against societies is real rather than apparent. Of these, perhaps the least understood is bioterrorism: “the unlawful or threatened use of microorganisms or toxins derived from living organisms to cause death or disease in humans, animals, or plants so as to create fear in the public or intimidate governments.” ¹

In a situation where uncertainty is high, how do citizens react? Few studies have attempted to provide insights into the way the public may respond to issues, topics, or practices people think are threatening or risky. ² So far, decision analysts have suggested two approaches: the technical or rational and the normative or value-laden approach. This study investigates which of these two approaches predicts people’s level of worry and dread before, during and after a bioterrorist event, and offers suggestions to help mitigate such legitimate public reactions.

Recent experiences with biological attacks have raised new and heightened national security concerns. In November 2009, perhaps as a scare tactic, envelopes mailed from Dallas to foreign consulates in Manhattan were found to contain a suspicious powder, but field tests came back negative for dangerous substances. ³ An incident in 2001, however, was lethal. Letters contaminated with anthrax, sent to media companies and the Washington, DC offices of two senators, resulted in twenty-three cases of infection, five deaths, and the contamination of numerous U.S. Postal Service facilities. ⁴ Department of Homeland Security experts warned that the spores released in this case could be used to seed the bio-weapons programs of “rogue” countries like North Korea, and active terrorist groups such as Al Qaeda, the Marxist insurgents in Colombia, the Chechen resistance fighters against Russia, the Maoist rebels of Nepal, as well as domestic biological “unabombers.” ⁵ Natural epidemics are terrifying enough, but the notion that pathogens can be harnessed as weapons is even more chilling.

Historically, whenever biological weapons are deployed in terrorist events, they cause low casualties but high visibility. ⁶ Today, however, experts say there is no weapon more effective in creating havoc than microorganisms spread to large swaths of the population. ⁷ A 1993 report by the U.S. Congressional Office of Technology Assessment estimates that between 130,000 and three million deaths could follow the aerosol release of 100 kilograms of anthrax spores upwind of Washington, DC. ⁸

The prospect of epidemics caused by the deliberate release of biological agents on civilians, and the well-chronicled vulnerabilities of societies to large-scale disease outbreaks, fulfill the litany of factors hypothesized to lead to the amplification of risk: (1) the projected fatalities and injuries are high; (2) exposure to bioterrorism agents is expected to be widespread; (3) the effects on civilians can be immediate; (4) the impact on the future looks devastating; (5) the news media are the major “social stations” for amplification; (6) the origin of fatalities may be unknown in the period immediately after the attack; (7) the risks are likely to be shared across society; and (7) there is much uncertainty concerning when, where, and how the attack is going to happen. ⁹ As such, unlike most natural epidemics, bioterrorism incidents present atypical risk-communication challenges.

Even the prospect of experiencing bioterrorism incidents is likely to produce high levels of worry and dread among the public. Worry generally refers to mental distress or agitation resulting from concern for something impending or anticipated. Dread, on the other hand, is an emotion that ranges from extreme uneasiness to extreme fear in the face of a disagreeable prospect. The worry and dread factors involved in bioterrorism incidents may be intense because most biological weapons are inexpensive and can kill the same number of people as conventional, nuclear, and chemical weapons. ¹⁰ Another advantage biological agents offer to terrorists is that they can target and infect a large area, they are easily transmitted, and they are difficult to detect. ¹¹ Their pathology mimics other illnesses so that by the time the cause is identified, precious time is already lost.

Literature Review and Theoretical Framework

In the late 1980s, risk was defined as either a physical attribute (the positivistic view) or a social construct (the constructivist view). ¹² Sociologists have offered cultural, individual, and systems approaches to understanding risks. ¹³ Others have proposed a broader classification that differentiates between technical, psychological, sociological, anthropological, and geographical perspectives. ¹⁴ Most of these classifications, however, are more descriptive than analytical.

Although Ortwin Renn claims the positivistic view and the social constructivist view of risks are poor descriptions of reality, ¹⁵ the risk amplification and attenuation framework he and his colleagues at Clark University developed incorporates the dimensions of these two foundational perspectives. ¹⁶ Today, the technical or rational approach and the normative or value approach to understanding reactions to risky technology and events are still useful analytical tools with which to define and prioritize actions that must be taken for public safety and security. ¹⁷

If risk is indeed an objective property of events, measured as the probability of occurrence of adverse effects, Renn submits that the policy implications of these two approaches are obvious. ¹⁸ Grounded on economic theories of rational citizens, the technical/rational approach holds that people make risk decisions based on a personal cost-benefit analysis informed by scientific and technical data. From this perspective, opposition to anything experts define as “safe” results from not understanding or not knowing the actual “objective” risks. ¹⁹ Public opposition, in this case, is often defined as a problem in effective risk communication. ²⁰ Effective, in this context, usually means improved methods of presenting technical risk information.

Sandman defines risk perception as ensuing from the combined impact of hazard and outrage (risk = hazard + outrage). ²¹ The technical/rational approach is akin to how Sandman conceptualizes “hazard,” which he illustrates as resulting from experts’ judgments and evaluations of risk. The hazard dimension of Sandman’s definition implies that public resources are allocated following objective measures of probability and magnitude of harm arising from risk and risk events as defined by experts.

But the risks that do damage and the risks that raise concerns are completely different, Sandman observes. ²² According to cognitive psychologists and decision analysts, this may be because the public is not composed of adroit technical decision-makers. This observation leads to the proposition that there are psychological and social variables that mitigate risk perception. Among them are the signal potential of cultural symbols and signs whose impacts derive from the meanings people attach to them in active interaction with their social environment. If the risk is seen as a cultural or social construction, as in the case of the normative/value approach, risk priorities and management should reflect social values, lifestyle preferences, and people’s psychographic characteristics, among others. The task of risk communication, in this case, is to improve the correlation between technical assessments and public concern. ²³ To enhance public confidence in the system that manages the risk, risk communicators must understand people’s underlying risk-assessment systems and values.

According to the normative/value approach, people incorporate a number of “qualitative” dimensions in their decisions about risky technologies: the object or event’s catastrophic potential and controllability, the scientific uncertainty surrounding it, its equity dimension in terms of who should bear the risk, and the threat it poses to future generations, among others. ²⁴ Those stressing normative/value elements argue that the decision maker is not an isolated entity using a restricted range of information. They emphasize contextual factors, such as social networks, organizational memberships, social class, and cultural understanding evolving from a history of technological successes and failures. ²⁵ In other words, based on this perspective, debates about risky topics, issues and practices require far more than technical risk estimates; they involve religious, moral, political, and psychological considerations as well. ²⁶

Which of these two approaches and the factors that constitute each of them have the greatest impact on the risk decisions of ordinary citizens? This question is of more than academic interest; it involves issues of resource allocation and the likelihood of success in overcoming or minimizing public opposition to a new technology or a new practice, or in preparing them for hazardous attacks.

To account for people’s level of worry and dread about experiencing bioterrorist events following the technical/rational approach, we assess the relative impact of four potential predictors: (1) knowledge of bioterrorism, (2) exposure to news coverage of bioterrorism, (3) attention to news coverage of bioterrorism, and (4) education. The media variables are critical in this conception because the technical/rational approach is hypothesized to become stronger in the presence or absence of risk communications that impart scientifically-based information about the threatening event and how to protect people against the direct and indirect consequences of these events. Bioterrorism is an issue that requires some grounding in the sciences to be clearly understood. As such, level of education also is predicted to influence risk attitudes and degrees of worry.

Among those who advance the normative/value approach are the proponents of the social amplification of risk framework (SARF), who argue that the risk experience is “not only an experience of physical harm but the result of processes by which groups and individuals learn to acquire or create interpretations of risk.” ²⁷ Using this framework, risk perception can be evaluated by recognizing the physical harm experts attach to a risk event, the social and cultural processes that shape interpretations of that event, the consequences of the event, and the response of risk managers and publics to that event. ²⁸

An element important to SARF is the role of public trust in different institutions, such as regulatory bodies, government agencies, and the mass media in mediating public responses to potential hazards. Lynn Frewer proposes that the extent to which people trust or distrust these institutions may affect the way they process risk information. ²⁹ Indeed, the importance of source characteristics such as credibility and honesty has long been recognized in social psychological models of attitude change. ³⁰ Intensive media coverage, according to Jeanne and Roger Kasperson, may not be a sufficient condition for amplification, but “trust may be a critical issue in the mediation of whether amplification occurs, as is public perception of the effectiveness of the handling of the hazardous event by authorities, which may, in turn, impact on the extent to which the authorities themselves are perceived to be trustworthy.” ³¹ In this study, the dimension of trust is measured using people’s perceived satisfaction over the level of national and local preparedness to prevent, counter, and bear the brunt of bioterrorist attacks.

Thus, if the normative/value perspective dominates public reactions, then the following factors are hypothesized to explain people’s levels of worry and dread about experiencing bioterrorist events: (1) trust in the news media, (2) trust in interpersonal communication sources, (3) trust in government agencies and institutions, (4) trust in universities and advocacy groups, (5) alienation from the government, and (6) the perceived preparedness and readiness of the nation to protect itself and to counter bioterrorist attacks.

The conceptual framework that outlines the two approaches and the factors that comprise each of them are shown in Figure 1.

Methodology

Data for this analysis were gathered using a national mail survey. The original sample of 2,000 names and addresses used in this study was randomly drawn from the white pages of city, suburban, and rural telephone directories across the continental United States. All respondents were adults, eighteen years of age and older, who responded to a structured survey questionnaire sent by mail. By sending a reminder postcard three weeks after the first wave, and mailing to a follow-up second wave two weeks later, 363 completed questionnaires were received. Of the original 2,000, 229 were returned as undeliverable, reducing the total number of questionnaires successfully mailed to 1,771 and resulting in a response rate of 20.5 percent.

The Dependent Variables

The first dependent variable – worry about bioterrorist events – was measured by asking respondents, “How worried are you about terrorism through biological means (such as the use of mail contaminants like anthrax and the release of other pathogens to cause human, animal and plant infections)?” The response range was 1 to 5 where 1 was “not worried” and 5 meant “very worried.”

Nine items tapped the dimensions of the second dependent variable, level of dread. These items asked respondents the extent to which they agreed with the following statements: (1) I have enough information to protect myself and my family against bioterrorist attacks; (2) The government is well prepared to protect the nation against bioterrorist attacks; (3) The state and local governments are well prepared to protect their constituents against bioterrorist attacks; (4) More research needs to be done on how to protect the public against bioterrorism; (5) The idea that food and water can be contaminated with deadly pathogens frightens me; (6) The Department of Homeland Security’s color-coded threat and security advisory helps considerably in alerting the public about all kinds of terrorist threats; (7) I know where to get help in case of bioterrorist attacks; (8) The media do a good job of informing me about the dangers posed by potential bioterrorist attacks, and (9) I am powerless against terrorist attacks. The response to these items ranged from 1 to 5, where 1 meant “strongly disagree” and 5 meant “strongly agree.” The sum of the responses to all items was averaged to measure people’s level of dread. ³² The items comprising this multidimensional variable were found to be internally consistent; the reliability of the scale was alpha=0.61. ³³

The Predictor Variables Using the Technical/Rational Approach

The technical/rational approach suggests a number of variables that may affect public perceptions of the risks inherent in bioterrorist acts. The variables of interest in this study were (1) knowledge of bioterrorism, (2) exposure to news coverage of bioterrorism, (3) attention to news coverage of bioterrorism, and (4) education.

Knowledge of bioterrorism was measured by the respondents’ scores on a ten-item quiz composed of close-ended objective questions asking them about different aspects of bioterrorism (i.e., bioterrorism agents, the most commonly used pathogens in terrorism acts, the “symptoms” of bioterrorist attacks, scientific risk assessments of hazards attendant to bioterrorist attacks, commonly recommended cures, and the things they should do if a deadly virus were unleashed in their town). Respondents were asked to indicate whether each statement was true or false. The sum of correct answers was used to measure knowledge.

To gauge exposure to mediated news, respondents were asked how often they access newspapers, talk shows, magazines, websites or other programs that discuss bioterrorism on a scale of 1 to 5 where 1 meant “hardly ever” and 5 meant “every day.” The means of people’s answers to exposure questions across media – television, radio, print and online newspapers, print and online magazines, and other web-based sources – were computed to arrive at an overall measure of exposure to bioterrorism-related news coverage. A reliability test of the index gave an alpha of 0.69.

Attention to bioterrorism coverage was measured by asking respondents to indicate how closely they attend to programs about bioterrorism they see on television, listen to over the radio, read in newspapers and magazines, and view in online news sources. The average of their answers to these questions across media was computed to arrive at an overall measure of attention to bioterrorism-related news coverage. The items comprising this scale were found to be internally consistent; the reliability of the scale was alpha=0.89.

Education was a categorical variable measured by asking respondents the highest level of formal education they have completed.

The Predictor Variables Using the Normative/Value Approach

Using the normative/value approach, the following factors were hypothesized to explain levels of worry and dread: (1) trust in the news media, (2) trust in interpersonal communication sources, (3) trust in government agencies and institutions, (4) trust in universities and advocacy groups, (5) alienation from the government, and (6) the perceived preparedness and readiness of the nation to counter and respond to bioterrorist attacks.

Respondents were asked how much they trust five mediated sources of information (magazines, radio and TV news programs, newspapers, and the online editions of newspapers and magazines) on a scale of 1 to 5 where 1 meant “do not trust at all’ and 5 meant “trust very much.” The sum of the responses to these scales were averaged and used as a measure of trust in mass media. The alpha coefficient of internal reliability for these four items was 0.79.

The respondents’ evaluations of trust in interpersonal communication channels were treated the same way, so that the trust estimates for family, friends, and doctor or primary health care provider were summed and averaged to form this index. The three items comprising the index were found to be internally consistent (alpha=0.68).

The factor trust in government agencies and institutions was composed of the respondents’ assessments of six government entities most concerned with national security and protection: the Centers for Disease Control, the U.S. Food and Drug Administration, the Environmental Protection Agency, the U.S. Department of Agriculture, the Department of Homeland Security, and public health officials. The reliability of the index was ascertained at alpha=0.88.

Trust in universities and advocacy groups was measured by the overall assessments of trust in the American Medical Association, food companies, churches and religious organizations, university scientists, and consumer advocacy groups. The reliability of this trust index was alpha=0.65.

The three-item alienation from government index measured the degree to which the respondents believed that (1) the federal government can protect the country in the case of a terrorist attack, (2) state and local governments can protect the country in the case of a terrorist attack, and (3) government at all levels is powerless against any terrorist attack. The items that constitute this index were found to be internally consistent (alpha=0.62).

The respondents’ level of satisfaction regarding the preparedness and readiness of the nation to counter bioterrorist attacks was measured by computing for the average of their responses to six questions that asked how satisfied they were about (1) the safety of the country’s reservoirs and water supply, (2) the inspection process for imported food, (3) the readiness of national government, (4) the preparedness of state and local governments to respond to a bioterrorist attack, (5) the potential availability of vaccines, and (6) the availability of antibiotics or antidotes in the event of a threat or in times of crisis. The answers to these scales ranged from 1 to 5, where 1 was “not satisfied at all” and 5 meant “highly satisfied.” This was found to be a reliable index (alpha=0.88).

The impact of the demographic variables of age, income, and gender on the two dependent variables were also ascertained.

Each of the two dependent variables was subjected to multiple and hierarchical regression analysis to determine the amount of change in levels of worry and dread accounted for by the thirteen predictor variables listed above.

Results and Discussion

The Sample’s Demographic Characteristics

Of the 363 respondents, 244 or 67.2 percent were males. The sample is relatively mature, with a mean age of 54.85 years, ranging from eighteen to ninety-seven years. A little more than a quarter of respondents (105 or 28.9 percent, the mode) have gone to vocational schools or have had some college experience; ninety-three (25.6 percent) have completed college and eighty-five (23.4 percent) have had postgraduate training. The mode for total household income from different sources is $25,000 to $49,999, with the median lying at the $50,000 to $74,999 range. The majority was Caucasian (81 percent).

The sample did not meet the expectation that few would have much knowledge of bioterrorism – the agents that may cause it, the ways in which dangerous pathogens can be released, the symptoms of an attack, the nature of the ensuing epidemics, and the direct and indirect consequences of bioterrorist acts. Most of the respondents gave the correct answer to eight of the ten-item knowledge quiz (m=8.06, sd=1.64).

The respondents’ high level of knowledge about bioterrorism is perhaps triggering a similarly high level of alienation from the government and the efforts it has shown so far to protect them against terrorist threats. This level of alienation may have been exacerbated by the fact that 69.3 percent of them disagree to strongly disagree that the federal government is well prepared to protect the nation against bioterrorist threats (m=3.93, sd=1.03). Close to 73 percent disagree to strongly disagree that the state and local governments have developed strategies to protect citizens against such attacks (m=4.03, sd=0.97). However, a little more than half (50.2 percent) disagree to strongly disagree that the government is powerless against these threats (m= 2.47, sd=1.15). These findings indicate the presence of a high level of concern among citizens about the government’s ability to counter bioterrorist threats and a perception that government at all levels remain unprepared against such attacks. Nevertheless, most admit the government has the power to do something to quell attacks.

The Sample’s Mass Media Habits

As shown in Table I, the respondents report watching television news (60.5 percent) and reading about bioterrorism in print and online newspapers “once in a while” to “somewhat often” (71.8 percent). They say they were exposed “once in a while” (44.3 percent) to bioterrorism content in magazines (print and online), other Web sources (53.4 percent), and radio news (54.9 percent), in that order. When asked how much attention they pay to news items about bioterrorism, they say they pay “fair” to “close attention” to TV (67.4 percent), newspaper, radio (46.8 percent) and magazine reports (36.6 percent), but “very little” to “fair” attention to news concerning this issue in Web sources (30.3 percent) outside of the online editions of newspapers and magazines.

The Sources the Respondents Trust

Table II lists the different sources of information (categorized as interpersonal, mass media, government, and university and advocacy groups) and the respondents’ trust of these sources. The table shows that family members were the most trusted source of information about bioterrorism, followed by the Centers for Disease Control, their doctor or primary health care provider, the American Medical Association, and public health officials, in that order. Two of the five most trusted sources were interpersonal communication sources, and the rest were government agencies and individuals in charge of health care and medical research.

What Respondents Think About the Government and Bioterrorism

The question “How worried are you about bioterrorism?” generated a slight majority (120 or a little more than 34 percent) saying they were “somewhat worried” about it (m=3.0, sd=1.18). As shown in Table III, only forty-four (12.5 percent) said they were “very worried” about bioterrorist threats. The clustering of responses, however, was in the “a little worried” to “worried” range (76 percent), a pattern that indicated some ambivalence about perceived threat. This level of worry is somehow incongruent with people’s optimism that the government has the ability to ward off a bioterrorist attack.

As is evident in Table III, the level of dread is high, with majority of the respondents (70 percent) reporting they disagree to strongly disagree that they have enough information to protect themselves and their family against such attacks, that the federal government is ready (70 percent), that the state and local governments are well prepared to protect the nation (73 percent), and that the media are doing a good job of informing them about the dangers potential attacks pose (49 percent). Most of them agree to strongly agree that more research needs to be done on how to protect the public (74 percent), and 56 percent were frightened by the possibility that food and water can be contaminated with deadly pathogens. Only 37 percent agree to strongly agree that the Department of Homeland Security’s color-coded threat and security advisory helps considerably in alerting the public to all kinds of terrorist threats. Less than 8 percent know where to get help in case of attacks. As Table III shows, the intensity of responses was higher for level of dread.

The Influence of Technical/Rational Variables on Level of Worry and Dread

This study aims to determine what factors account for levels of worry and dread. Table IV presents the summary results of four separate multiple linear regression tests that sought to determine the impact of the technical/rational variables and normative/value variables on worry and dread about bioterrorism. For these analyses, the regression method “enter” was used, placing all variables in the equation in blocks regardless of their statistical significance.

The results show that the four technical/rational variables combined in one block were significant predictors of level of worry, accounting for 30.4 percent of the explained variance [F(4,63)=6.87, p=.000]. Controlling for the impact of media exposure, education, and knowledge of bioterrorism, a significant regression equation was found when testing for the influence of media attention on level of worry (t=4.17, p=0.000). Thus, of the technical/rational variables, attention to media was the only significant predictor. Based on the results, the respondents’ level of worry was fueled by exposure and attention to media, but reduced by years of schooling.

The results of a multiple linear regression test predicting the level of dread based on influence of technical/rational variables show a very different picture (Table IV). This time, none of the technical/rational independent variables significantly predicted level of dread. The regression equation was not significant [F(4,62)=0.619, p=0.651], with the four variables combined explaining only 4 percent of the variance. Therefore, none of the technical/rational variables had a bearing on level of dread.

The Influence of Normative/Value Variables on Level of Worry and Dread

A multiple linear regression was calculated to predict respondents’ level of worry about a bioterrorist attack based on the six predictor variables hypothesized following the normative/value approach (Table IV). A significant regression equation was found [F (6,240)=4.14, p=0.001] for the influence of this combined block of independent variables on level of worry. Of these, the perceived preparedness of the country to stave off terrorist attacks contributed substantially to the variance (t=2.30, p=0.022). All of these factors were positive contributors to level of worry, except for trust in interpersonal communication and perceived readiness of the country to prevent attacks, both of which reduced worry. However, the extent to which people perceived the government as ready to protect them was the only significant predictor of the respondents’ level of worry.

A multiple linear regression was calculated to predict respondents’ level of dread about a bioterrorist attack based on six predictor variables following the normative/value approach. This time, the block of normative variables was a very highly significant predictor [F (6,245)=24.29, p=0.000]. A significant regression equation was found for trust in universities and advocacy groups (t=2.122, p=0.035), alienation from government (t=9.019; p=0.000), and perceived readiness of the government to counter terrorist attacks (t=3.561, p=0.000). That is, trust in government and interpersonal sources, as well as perceived government readiness to counter threats, reduced level of dread. Because this equation showed more significant contributors to level of dread, the finding supports the contention that normative/value variables are stronger predictors of level of dread than rational/technical factors.

Hierarchical Tests Controlling for Demographics

To determine the strongest predictors of levels of worry and dread, two hierarchical multiple regression tests were employed. These stringent tests were meant to determine the influence of the two sets of predictor variables and demographic characteristics on worry and dread. In these two tests, the influence of gender, age and income were combined to form the first block of independent variables. The technical/rational variables constitute the second block, and the normative/value predictors made up the third block.

Table V presents the results of a multiple regression analysis with level of worry as the dependent variable. The results show that the block of technical/rational variables contributed significantly to level of worry, but the block of normative variables showed limited contribution. The strength of the technical/rational block can be attributed to attention to mass media bioterrorism content (t=5.08, p=0.000). Demographic variables did not predict changes in the dependent variable. Although females were likely to be more worried about bioterrorism than males, attention to media content was the strongest predictor of the extent to which people were worried about bioterrorist incidents in the country.

The influence of the same set of independent variables on level of dread was also determined (Table V). The results indicate that only the block of normative/value variables significantly predicted level of dread [F(13,39)=13.52, p=0.000], explaining a large percent of the variance (82 percent). Of the variables in this block, trust in interpersonal sources (t=2.84, p=0.007), feeling alienated from the government (t=5.32, p=0.000), and perceived ability of the government to counter threats (t=5.61, p=0.000) were the significant contributors to level of dread. In this examination of the combined impact of other potential contributors, age (t=2.04, p=0.048) and income (t=2.25, p=0.030) also exerted some influence (those who were younger and have higher incomes dread bioterrorism more) although the block of demographics did not exhibit a significant contribution. Media exposure (t=-3.30, p=0.002) and attention to media (t=2.36, p=0.024) also showed some predictive power.

As a block, however, the technical/rational variables’ contribution was not significant. The results again showcased the impact of the normative variables on dread. Trust in interpersonal sources, feeling alienated from the government, and perceived ability of the government to respond to threats significantly predicted the respondents’ level of dread.

In summary, the technical/rational variable media attention predicted level of worry when the impact of only the technical/rational variables was analyzed and when the influence of technical variables was combined with that of the normative/value predictors and demographic characteristics. The normative variable perceived government preparedness to counter terrorist threats was found to significantly reduce level of worry (Table VI).

When the influence of the two sets of factors, including the demographic variables age, gender, and income were combined, the technical/rational variables media exposure and attention significantly predicted level of dread. Specifically, media exposure tended to heighten dread, but more attention to the content of media reports seemed to reduce this effect. The normative factors, however, had a greater impact on dread. Specifically, trust in interpersonal sources, feeling alienated from the government, and perceived government preparedness considerably lessened it (Table VII).

Conclusions

The mean of this national sample’s response showed ambivalence in respondents’ level of worry about the use of biological organisms as weapons of terrorism. Their level of dread, however, was more than their reported level of worry, indicating that they fear the prospect of bioterrorist attacks.

The results of multiple regression tests indicate that although the two dependent variables, level of worry and level of dread, were significantly related (r=0.18, p=0.016), they were distinctly different, judging by the variables that predict their strengths. Level of worry was significantly influenced by variables representing the technical/rational perspective. In this case, attention to mass media was the dominant factor. On the other hand, variables that stem from the normative/value perspective – trust in university and advocacy groups, trust in interpersonal communication sources, alienation from government and perceived readiness of the government to protect the nation – accounted for level of dread. Those who paid more attention to mass media bioterrorism content were more worried about bioterrorist attacks, while those who felt satisfied that the nation is prepared to respond to terrorist threats were less worried about it. Even when the influence of other variables was considered, attention to mass media was the strongest predictor of level of worry.

Variables from the two approaches accounted for level of worry, but the normative/value variables predicted higher dread. People who were alienated from government and who perceived the country as incapable of handling terrorist threats showed higher levels of dread. The results of the hierarchical regression analyses demonstrated the impact of trust in advocacy groups and on interpersonal communication sources on level of dread. Trust in these two sources figured prominently because bioterrorist threats are associated with too much uncertainty and too little government control. The factors that lead to higher dread suggest that effective risk communication may be more a problem of ensuring trust and confidence in the government’s ability to protect the nation from terrorist threats than it is an issue of explaining bioterrorism in lay terms.

Implications for Policy

People’s reactions before, during and after a threatening event can be intense and complex. Emergencies like bioterrorist attacks may engender more panicked reactions and may prompt a debilitating response, with people potentially acting in irrational ways. The findings of this study indicate that the mass media, specifically television and newspapers (print and online), are the best ways to reach people during such an emergency situation because people are exposed to and attend to them almost as a matter of habit. Indeed, exposure and attention to the mass media were found to mitigate levels of worry and dread. The results also suggest the need for the general public to be aware of and have access to preparedness plans because people have implicit trust in family members who are not likely to be experts on the hazards bioterrorist attacks engender.

Any threatening event demands credible and accurate information from sources of authority. The findings clearly point to the Centers for Disease Control and the American Medical Association as entities that enjoy considerable public trust and can therefore lead the communication effort. People also may resort to primary health care providers and other public health officials as trusted interpersonal sources of information. These individuals, therefore, constitute an important audience segment that may demand more information to be able to respond to face-to-face inquiries.

Perhaps as important as identifying the outlets for information dissemination, risk communicators should endeavor to ascertain the factors that underlie levels of worry and dread. The results suggest that during such an uncertain period, normative/value factors exert a greater influence on the extent to which people may be worried or have feelings of dread. Trust in universities and advocacy groups and interpersonal sources; alienation from government; and perceived government preparedness to handle such attacks were found to be significant predictors of worry and dread. Thus, a preparedness plan must incorporate practices intended to enhance public trust.

A bioterrorism incident offers a test case for crisis communication because such an event is characterized by a continuous sense of urgency and a rapid rate of change. In these situations, messages may be confusing, contradictory, and subject to change as the events evolve. In cases like this, people may experience a range of strong emotions, including fear, anger, panic, denial, laying blame, strong solidarity with others, a desire to help victims, and the need for personal control. All these may affect how they respond to a risk. Communication must account for these responses, including giving people reasonable and appropriate actions to take. Messages should not try to over-reassure or convince people there is nothing to be afraid of. Instead, it is important to acknowledge and accept that worry and dread are legitimate reactions, and then tell people what is being done and what they can do.

Another trust-enhancing practice is to address misperceptions at the planning stage and during the emergency. Designated trained spokespersons should explain what is known at the time and what is unknown, pinpointing what is preliminary and indicating what is being done to find out more. They must also concede errors and modify previous statements as more information comes to light. This is so because people want honest and accurate information about terror-related situations even if it makes them worried and highly fearful.

A public that has sympathized with its government in the aftermath of 9/11 has also been made irate by government inaction during and after Hurricane Katrina. This is perhaps why, although people indicate reservations about the government’s ability to protect citizens during terrorism incidents, they still believe it can do more to enhance national security and well-being. The measures outlined above tap into this sentiment and can serve as the basis for maintaining public trust. Simply put, as the findings indicate, if one can trust, one can take the risk.

Lulu Rodriguez is professor in the Greenlee School of Journalism and Communication at Iowa State University. She holds a joint appointment with Iowa State’s Biosafety Institute for Genetically Modified Agricultural Products. Dr. Rodriguez teaches courses in science and risk communication and researches consumer opinions about controversial agricultural technologies and the visual communication of risk. She earned her PhD in mass communication from the University of Wisconsin-Madison. Dr. Rodriguez may be reached at lulurod@iastate.edu.

Suman Lee is assistant professor in the Greenlee School of Journalism and Communication at Iowa State University. He teaches courses in public relations and strategic communication. Dr. Lee’s primary research interest centers on international and global issues of public relations and how organizations can build mutually beneficial relationships and communicate effectively with various publics in the context of internationalization and globalization. He earned his PhD in mass communication from Syracuse University. Dr. Lee may be reached at smlee@iastate.edu.

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1. R. Gregory Evans, “Bioterrorism and food safety,” paper presented at the annual conference of the Jamaica Association of Public Health Inspectors, in Trelawny, Jamaica (2004), 2.↵
2. See, for example, Judith A. Bradbury, “The Policy Implications of the Differing Concepts of Risk,” Science, Technology, and Human Values 14 (1989): 380-399; Jurgen Markowitz, “Kommunickation uber Risken,” Schweizerische Zeitschrift fur Soziologie 3, No. 90 (1991):385-420; Steve Rayner, “Risk and Relativism in Science for Policy,” in The Social and Cultural Construction of Risk, eds. B. Branden, B. Johnson, and Vincent T. Covello, 5-23 (Dordrecht: Reidel, 1987); and Brian Wynne,“Public Perceptions of Risk,” in The Urban Transportation of Irradiated Fuel, ed. John Surrey, 246-32 (London: Macmillan, 1984).↵
3. Associated Press, “Suspicious Powder sent to NYC Consulates,” CBS News, November 10, 2009, http://www.cbsnews.com/stories/2009/11/10/national/main5598754.shtml.↵
4. U.S. General Accounting Office (GAO), Better Guidance is Needed to Improve Communication Should Anthrax Contamination Occur in the Future: Report to the Ranking Minority Member Committee on Governmental Affairs (U.S. Senate. Washington, DC: General Accounting Office, 2003).↵
5. U.S. Department of Homeland Security (DHS), Defending Against Biological Terrorism (Washington, DC: DHS, 2002), http://www.dhs.gov/dhspublic/interapp/press_release/press_release_0050.xml.↵
6. Jonathan B. Tucker, “Historical Trends Related to Bioterrorism: An Empirical Analysis,” Emerging Infectious Diseases 5 (1999), http://www.cdc.gov/ncidod/eid/vol5no4/tucker.htm.↵
7. Evans, “Bioterrorism and Food Safety.”↵
8. U.S. Congressional Office of Technology Assessment, Report on Threat Posed by Bioterrorism Agents (Washington, DC: Government Printing Office, 1993).↵
9. Jeanne X. Kasperson and Roger E. Kasperson, “Corporate Culture and Technology Transfer,” in Corporate Environmentalism in a Global Economy: Societal Values in International Technology Transfer, ed. Halina S. Brown, Patrick Derr, Ortwin Renn, and Allen White, 140-170 (Westport, CT: Quorum Books, 1993); Peter N. Sandman, “Bioterrorism risk communication policy,” Journal of Health Communication 8 (2003):146-147.↵
10. Evans, “Bioterrorism and Food Safety.”↵
11. DHS, Defending Against Biological Terrorism.↵
12. Bradbury, “Policy Implications of the Differing Concepts of Risk.”↵
13. Peter J. May, “Social Science Perspective: Risk as Disaster Preparedness,” International Journal of Mass Emergencies and Disaster 7 (1989):281-303; Rayner, “Risk and Relativism in Science for Policy;” Wynne, “Public Perceptions of Risk.”↵
14. Thomas R. Dietz, R. Scott Frey, and Eugene A. Rosa. 1990. Risk, Technology and Society,” in Handbook on Environmental Sociology, ed. Riley E. Dunlap and William Michelson (Westport, CT: Greenwood, 1990).↵
15. Ortwin Renn, “Concepts of Risk: A Classification,” in Social theories of risk, ed. Sheldon Krimsky and Dominic Golding (Westport, CT: Praeger Publishers, 1992).↵
16. Jeanne X. Kasperson, Roger E. Kasperson, Nick Pidgeon, and Paul Slovik, “The Social Amplification of Risk: Assessing 15 Years of Research and Theory,” in The Social Amplification of Risk, ed. Nick Pidgeon, Roger E. Kasperson, and Paul Slovic (New York: Cambridge University Press, 2003).↵
17. Mary Douglas and Aaron Wildavsky, Risk and Culture: An Essay on the Selection of Technology and Environmental Dangers (Berkeley, CA: University of California Press, 1982); Sheldon Krimsky and Alonzo Plough, Environmental Hazards: Communicating Risk as a Social Process (Dover, MA: Auburn House, 1988).↵
18. Renn, “Concepts of Risk.”↵
19. Raphael G. Kasper, “Perceptions of Risk and Their Effects on Decision Making,” in Societal Risk Assessment: How Safe is Safe Enough?, ed. Richard C. Schwing and Walter A. Albers, Jr., 71-84 (New York: Plenum, 1980); Harry J. Otway and Kerry Thomas, “Reflections on Risk Perception and Policy,” Risk Analysis 2 (1982):69-82.↵
20. Vincent T. Covello, Paul Slovik, and Detlof Winterfeldt, Risk Communication: A Review of the Literature (Washington, D.C.: National Science Foundation, 1987).↵
21. Sandman, “Bioterrorism Risk Communication Policy.”↵
22. Peter N. Sandman, “Anthrax, Bioterrorism, and Risk Communication: Guidelines for Action,” The Peter Sandman Risk Communications Website (December 29, 2001), http://www.psandman.com/col/part1.htm.↵
23. Ibid.↵
24. Paul Slovik, “Perception of Risk: Reflections on the Psychometric Paradigm,” in Social Theories of Risk, eds. Sheldon Krimsky and Dominic Golding (Westport, CT: Praeger Publishers, 1992).↵
25. Douglas and Wildavsky, Risk and Culture.↵
26. Harry J. Otway and Detlof von Winterfeldt, “Beyond Acceptable Risk: On the Social Acceptability of Technologies,” Policy Sciences 14 (1982):247-256.↵
27. Kasperson and others, “The Social Amplification of Risk,” 15.↵
28. Ibid.↵
29. Lynn J. Frewer, “Trust, Transparency, and Social Context: Implications for Social Amplification of Risk,” in The Social Amplification of Risk, eds. Nick Pidgeon, Roger E. Kasperson, and Paul Slovic (New York: Cambridge University Press, 2003).↵
30. Richard E. Petty, and John T. Cacioppo, “Source Factors and the Elaboration Likelihood Model of Persuasion,” Advances in Consumer Research 11 (1984):668-672; Richard E. Petty and John T. Cacioppo, Communication and Persuasion: Central and Peripheral Routes to Attitude Change (New York: Springer-Verlag, 1986).↵
31. Kasperson and Kasperson, “Corporate Culture and Technology Transfer,” 125.↵
32. Creating composite scores, or scales, from groups of responses to a questionnaire is a common practice. This is usually done for ratio and ordinal variables with similar response ranges. A well-constructed scale has good reliability (internal consistency and reproducibility over time) and validity (it measures what you want it to measure).↵
33. Many variables or constructs have multiple dimensions. To measure these variables, it is necessary to ask several questions (usually Likert scale items) of survey respondents. Cronbach’s alpha indicates how well a set of items measures a single construct. Technically speaking, Cronbach’s alpha is not a statistical test but a coefficient of reliability. It is a function of the number of items and the average inter-correlation among these items. As the average inter-item correlation increases, Cronbach’s alpha increases as well. If the inter-item correlations are high, there is evidence that the items are measuring the same underlying construct, the basis for saying that reliability is “good” or “high.” A reliability coefficient of 0.60 or higher is considered “acceptable” in most social science research situations.↵

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