Health risk perception measures: A systematic literature review

Health risk perception (HRP) determines health behaviors. HRP measures with the psychometric property might be scarce. A systematic literature review was conducted. Keywords “Perceived risk” and “risk perception” were combined with COVID-19, “Coronavirus disease 2019”, “Social distance*”, “Facial mask”, Handwash*, and “Hand hygiene” to search the article in Cochrane Library, PsycINFO, PubMed, and Scopus databases. Only peer-reviewed journal articles written in English and published between 2009 and 2020 were included for review. Articles based on laboratory experiments and non-human participants were excluded from the review. The narrative synthesis technique was used to analyze data. Sixty-eight articles were identified from 25 countries. All of the studies were based on a cross-sectional design mostly using a questionnaire. Borg CR ratio scale and index were also used. Though the number of questions/items varies from 1 to 13, most measures had either 7 or 8 items. One measure was with 51 items. Many items were adapted from previous literature. A 5-point Likert-type scale was used in many measures. Few measures used 3-, 4-, 7-, 9- and 10-point scales. A couple of scales ranged from 0 to 100. Dichotomous scales were also used. A higher score indicated a higher sense of risk perception. Not all scales reported reliability scores. The reported lowest and highest Cronbach’s alpha were 0.64 and 0.76. Risk at different levels including individual, family, neighborhood, friends, community, society, own country, and even other countries were measured by those measures among health professionals and food handlers. Cognitive, affective, and temporal-spatial aspects/dimensions of risk perception of infection and death due to COVID-19, influenza, food poisoning, unprotected sex, cancer, binge drinking, and air pollution were measured by those scales. Travel risk perception measures were also found. In conclusion, we might need to construct a 5-point comprehensive and holistic measure of health risk perception with 7-10 items and acceptable psychometric properties.