Graduation Year


Document Type




Degree Granting Department

Public Health

Major Professor

Robert McDermott, Ph.D.

Committee Member

Eric Buhi, Ph.D.

Committee Member

Ellen Daley, Ph.D.

Committee Member

John Ferron, Ph.D.


Health Literacy, Health Communication, Quantitative Literacy, Risk Perception Attitude Framework, Risk Communication


Individuals have become more involved in health-related decisions, in part due to an unprecedented access to information that can be used to enhance both physical and mental health. Much of this health-related information is presented in a numerical format; unfortunately, research suggests many Americans may not possess the literacy skills necessary to comprehend numerical health-related information. More research needs to be conducted to examine numeracy and its role in cancer risk perceptions, and how those risk perceptions relate to cancer self-protective behaviors. The purpose of the current study was to: (a) examine socio-demographic variables associated with numeracy, (b) determine which factors are associated with cancer risk perceptions, and (c) apply the Risk Perception Attitude (RPA) Framework to examine associations between risk perception groups and cancer self-protective behaviors. The study used data from the 2007 Health Information National Trends Survey (HINTS), which was developed by the National Cancer Institute to collect nationally representative data on the U.S. public's use of cancer-related information. Logistic regression was used to assess the association between each dependent variable and independent variables associated with each research question. Results indicated age and education were associated with objective numeracy, whereas age, education, and occupational status were associated with subjective numeracy. Among participants with a previous cancer diagnosis, objective numeracy and smoking status were associated with a somewhat high/very high perceived risk of developing cancer in the future. Age, race/ethnicity, family cancer history, smoking status, and self-reported general health were associated with a somewhat high/very high perceived risk of developing cancer in the future among participants without a previous cancer diagnosis. RPA group was not significantly associated with cancer self-protective behaviors. Findings from this study have important implications for public health, including health communication and interventions designed to enhance health behaviors. Future research should focus on using a full objective numeracy scale with a nationally representative population and examining temporal relationships between cancer risk perceptions and health behaviors.