900
ANGLER ATTITUDES AND BEHAVIOR ASSOCIATED WITH
OHIO RIVER HEALTH ADVISORIES
by
Barbara A. Knuth, Nancy A. Connelly, and Michael A. Shapiro
ILLINOIS
Cairo
• PXtiburgh
PENNSYLVANIA
Wheeling
•
J_ .
WEST VIRGINIA
Paducah
HDRU Series No. 93-6
July 1993
Human Dimensions Research Unit . ;
Department of Natural Resources
.New York State College of Agriculture and Life Sciences
A Statutory College of the State University
Femow Hall, Cornell University, Ithaca, N.Y. 14853
Printed on Recycled Paper
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HUMAN DIMENSIONS RESEARCH UNIT PUBLICATIONS SERIES
This publication is part of a series of reports resulting from investigations dealing with
public issues in the management of wfldlife, fish, and other natural resources. The
Human Dimensions Research Unit (HDRU) in the Department of Natural Resources at
Cornell University is a nationally-recognized leader in the study of the economic and
social values of wildlife, fish, and other natural resources and the application of such
information in management planning and policy. A list of HDRU publications may be
obtained by writing to the Human Dimensions Research Unit, Department of Natural
Resources, Fernow HaB, Cornell University, Ithaca, NY 14853.
fflMJ
Human Dimensions Research Unit
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ANGLER ATTITUDES AND BEHAVIOR ASSOCIATED WITH
OHIO RIVER HEALTH ADVISORIES
by
Barbara A. Knuth, Nancy A. Connelly, and Michael A. Shapiro
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ACKNOWLEDGMENTS
We thank C. Houseknecht, U.S. Environmental Protection Agency, for his
support and assistance through all phases of this project. A. Vicory and J.
Schulte, Ohio River Valley Water Sanitation Committee, provided useful
insights at several stages of the project, including questionnaire development
and report preparation. A. Greene and R. Hoffmann, USEPA, reviewed the draft
questionnaire. We thank members of the Human Dimensions Research Unit (T. jlf
Brown, J. Enck, W. Siemer, R. Stout, H. Christoffel, C. Loker, B. Van Ornam,
™l"-,Aclcerb1ade) for reviewing the draft questionnaire, implementing the
mail survey, conducting telephone interviews, and coding data. H. Christoffel
also assisted with computer analysis and table preparation, and M. Ackerblade
helped draw the sample for the mail survey. M. Peech provided able assistance ^
typing names, addresses, and tables for this project. We thank each of the
Ohio River states for providing access to their fishing license records.
Comments of reviewers improved the report.
This project is a result of research sponsored by the U.S. Environmental ^
Protection Agency under Assistance-Agreement R 819571-01-0 through the Office
of Water.
. ' ' \
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TABLE OF CONTENTS
Pace
ACKNOWLEDGMENTS i
LIST OF TABLES iv
LIST OF FIGURES,., . . -, . . .-.-' .-, .... „., vi
EXECUTIVE SUMMARY .. vii
INTRODUCTION ............ . . 1
Objectives 4
Conceptual Background 4
External Variables 6
Beliefs and Attitudes 7
Behaviors ....... 7
AGENCY OBJECTIVES ASSOCIATED WITH OHIO RIVER HEALTH ADVISORIES ...... 8
Methods .......... ,. 8
Results and Discussion: Health Advisory Objectives and
Evaluation Criteria ..., 9
Health Advisory Objectives 9
Health Advisory Evaluation Criteria- 13
IMPACTS OF OHIO RIVER HEALTH ADVISORIES 22
, Methods 22
Mail Surveys . 22
Nonrespondent Follow-up . . 25
Statistical Analysis 26
Results and Discussion: Health Advisory Impacts 29
Survey Response . 29
Adjustments for Nonresponse Bias . 29
Determining the Population 31
Respondents Who Had Not Fished The Ohio River In
The Past Five Years 32
Respondents Who Fished The Ohio River In The Past Five Years . 34
External Variables . 34
Beliefs, Attitudes, and Behavioral Intentions 39
Advisory-related Behaviors . . 55
Communication Strategies .... 70
Conclusions and Recommendations Regarding Health Advisory Impacts . . 71
Recommendations for Agencies . . 71
Recommendations for Research .... 76
A SUMMARY OF RISK COMMUNICATION CONCEPTS FOR COMMUNICATING
HEALTH ADVISORIES 80
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TABLE OF CONTENTS (cent.)
Page
A Framework for Health Advisory Communication Programs . . 80
The Model ........ 80
Problem Analysis: Objectives -. 82
Audienc? Needs Assessment . . -.-. ... 83
Identifying target audiences 83
Audience information and communication needs . , ... . .., ;. 84
Audience behavior 86
Communication Strategy: Design and Implementation . . . . . . 87
Developing the advisory message 87
Styles for presenting advisory information . . . r~. .. . 87
Advisory dissemination mechanisms ..:... 88
Timing of advisory dissemination . . 89
Evaluating the Communication Program ............. 89
Summary 91
LITERATURE CITED . . 91
APPENDIX A: Listing of MSA and non-MSA Counties ..... . . . . , . . . .. 94
APPENDIX B: Spring and Fall Mail Questionnaires ..... 97
APPENDIX C: Tests for Nonresponse Bias and Calculations for
Nonresponse Adjustments ........ . . ........ 114
APPENDIX D: Detailed Tables ...... 120
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LIST OF TABLES
Table Title •
1 Objectives for health advisories identified by
representatives from state health, fishery, and
environmental quality agencies, and ORSANCO (n=15),
including means, standard deviations, and frequencies
of responses ...... :< , ..,.„,. 10
2 Major factors identified and factor loadings for 17 of
20 objectives rated according to importance. (Three
objectives, which focused on meeting legal mandates of
government agencies, discouraging fish consumption, and
informing people about health benefits from eating fish
were dropped from the analysis to improve reliability and
percent of variance explained.) . 14
3 Importance of health advisory evaluation criteria based
on responses from all state agency respondents and
ORSANCO (n=15), including means, standard deviations,
and frequencies ........ 17
4 Major factors identified and factor loadings for 18 of
19 health advisory evaluation criteria rated according
to importance. (One criterion, which focused on general
public awareness of advisories, was dropped from the
analysis to improve reliability and percent of variance
explained.) 20
5 Response rates for fall and spring surveys 30
6 For those who have not fished the Ohio River in the past
five years, percent of respondents checking various
reasons for why they have not fished the Ohio River in
the past five years. Respondents could check more than
one reason 33
* } • '
7 For respondents who fished the Ohio River in the past
five years, percent who were aware of the health
advisories-overall, by socio-demographic characteristics,
state of residence, and time of survey 35
8 The percent of respondents using each source of health
advisory information and the mean importance of that
source . . . 37
9 Angler path analysis regression results for Fis. 3 . 38
10 Beliefs about following the advisory and eating Ohio
River fish 41
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LIST OF TABLES (cont.)
Title Page
Opinions about whether eating some or any fish from the
Ohio River is safe by state of residence, advisory
awareness, timing of the survey, location fished most
frequently, and fish consumption groups ......._.- .42
12 'Evaluation of outcomes associated with following the
advisory and eating Ohio River fish . . . . 45
13 Angler path analysis regression results for Fig. 4 48
14 Control belief reasons for not following the
recommendations in the health advisories . . 50
15 Importance of scale items for respondents' satisfaction
with a fishing trip - . .. . .-•< . . - 54
16 Respondents' annual catch and consumption of Ohio River
fish species (1991-1992) . . . . , . 58
17 Respondents' catch and consumption of listed species-overall,
by socio-demographic characteristics, state of residence,
time-of survey, advisory awareness, days fished, location
""fished, and major sources of information 59
18 Percent of respondents in each fish consumption group
eating unlisted species and for those eating unlisted
species the average number of unlisted fish meals by
fish consumption group 62
19 Mean use of risk-reducing cleaning techniques for
respondents exhibiting low and high concern about the
safety of eating Ohio River fish by whether or not they
consumed fish above advisory limits 65
20 Changes made in response to the health advisories for
those who were aware of the advisories ............ 66
21 Correlation coefficients of four behavioral variables
with concern that eating fish could be a health risk, for
two thought-recall groups 69
22 Believability of sources of information regarding the
------ potential health risks from eating Ohio River fish 72
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LIST OF FIGURES
Figure Title * Page
1 Conceptual diagram of social-psychological process
determining response to health advisories, derived from
the Theory of Planned Behavior (Ajzen 1989), and
modified from Connelly et al. (1992) ..... 5
Map of study area 23
Path diagram of relationships between external variables,
with standardized regression coefficients from an
ordinary least squares regression. Asterisks indicate
significant values (p = .05) 38
Path diagram of social-psychological process determining
response to health advisories, with standardized regression
coefficients from an ordinary least squares regression.
Asterisks indicate significant values (p = .05) 47
VI
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EXECUTIVE SUMMARY
Fish consumption health advisories have been issued in the United States
since the mid-1970's, and specifically in the Ohio River Valley since 1988, in
response to concern over potential negative health consequences of consuming
sport-caught fish. Issuing health advisories with recommendations about
limiting consumption of fish and adopting other risk-reducing behaviors is the
primary management strategy being implemented by Ohio River Valley states to
address this problem (in addition to longer-term remediation and control
activities).
Advisories issued by different states bordering the Ohio River have not
necessarily contained the same recommendations, even for the same stretch of
.^ i i. ~'"'-' £ ': . ' _
the River. Proliferation of different advisories and communication strategies
raises questions about the impacts one or multiple advisories are having on
the audiences of interest. Further, differences among agencies regarding
objectives they seek to accomplish via health advisories may contribute to the
differences in approaches used to develop and communicate advisories with the
public.
The objectives of this study were to: (1) identify state and regional
agency objectives associated with state fish consumption health advisories in
the Ohio River Valley; (2) determine the impacts associated with Ohio River
health advisories including (a) awareness of, attitudes, and opinions about
health advisories held by Ohio River Valley anglers; (b) angler behavioral
changesHaVsociated withadvisories; and (c) effect of urban vs. "rural
residence, and recent vs. distant media attention relative to advisory
awareness and behavior; and (3) summarize risk communication issues to
consider when communicating health advisories to the public.
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A6ENCY OBJECTIVES ASSOCIATED WITH OHIO HIVER HEALTH ADVISORIES
We conducted telephone interviews with two or three individuals in each
state who had major responsibilities associated with health advisories. Each
telephone interview focused on perceived agency health advisory objectives and
opinions about criteria for evaluating the success of health advisories.
We completed 15 telephone interviews with 5 fishery agency
representatives, 5 health agency representatives, 4 environmental quality
1 -.-•;•: : .'- •
agency representatives, and 1 Ohio River Valley Water Sanitation Commission
representative.
Of 20 potential objectives presented to agency representatives, the most
important objectives for states overall included those focused on: (1) -—
reducing health risks for particularly at-risk groups, the general public,
licensed anglers, and subsistence fishers; and (2) helping people make their
own informed decision about cleaning, cooking, and eating Ohio River fish.
Differences exist in the importance placed on potential health advisory
objectives by fishery and health/environmental quality agencies. Fishery
' ' * "* r ' '
agencies placed greater emphasis than the environmental quality agencies on
objectives associated with public support and resource use, risk-reducing fish
preparation methods, and enabling people to make their own informed decisions
about fish consumption.
. • ' '•' ''•'-.- ' . •• . ' .
Nineteen potential health advisory evaluation criteria were presented to
agency representatives. The most important criteria identified included: (1)
advisory awareness; (2) use of risk-reducing fish preparation methods; (3) use
of fishing behaviors (i.e., species targeted, size kept); and (4) fish
consumption rates at or slightly below advisory recommendations. As with the
rating of objectives, differences exist between fishery and
health/environmental quality agencies in the importance placed on potential
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health advisory evaluation criteria. Fishery agencies assigned greater
importance than environmental agencies to evaluation criteria associated with
angler behavior and angler awareness.
IMPACTS OF OHIO RIVER HEALTH ADVISORIES
The second objective of this study was to determine the impacts
associated with Ohio River health advisories.
Methods
We implemented two mail surveys, one each in Spring and Fall, 1992, to
^
assess the effect of timing of advisory communications on health advisory
awareness and attitudes. Samples of 2,000 resident licensed anglers for the
spring survey and 3,000 resident licensed anglers for the fall survey were
obtained from the six states that border the Ohio River.
We used the results from the telephone interviews with agency personnel
(discussed previously), and findings from other studies, to develop a mail
questionnaire to be sent to the sample of licensed anglers. The questionnaire
was designed to determine the awareness of, attitudes and opinions about, and
behavioral responses to current Ohio River health advisories as well as
identify potential improvements to the advisories from the perspective of Ohio
River Valley anglers.
The spring survey was implemented in late April, 1992 and the fall
survey in late September, 1992. Up to three follow-up mailings were sent to
nonrespondents over the course of the following months.
A telephone follow-up to 151 nonrespondents to the spring survey was
conducted in June, 1992 and another one to 100 nonrespondents to the fall
survey in November, 1992 to provide an estimate of the degree to which
nonrespondents to the mail surveys differed from respondents.
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Results and Discussion: Health Advisory Impacts
For the spring survey, of the 2,000 questionnaires mailed, 142 were
undeliverable and 841 completed questionnaires were returned. This resulted
in an adjusted response rate of 45.3%. For the fall survey, of the 3,000
questionnaires mailed, 262 were undeliverable and 1,269 completed
questionnaires were returned. This resulted in an adjusted response rate of
46.3%. rr
In this study, we sought to contact people with Ohio River fishing
experience. We defined "Ohio River experience" as including only those
respondents who had fished the Ohio River in the past five years or had eaten
Ohio River fish in the past year. Respondents who had no Ohio River fishing
experience accounted for 38% of our spring sample and 44% of our fall sample. £
The majority of respondents did not fish the Ohio River because they
preferred other locations or because they would not want to eat the fish due
to contaminants. Respondents could check as many reasons for not fishing as
they wished. Nineteen percent of respondents who had not fished the Ohio ^
River in the past five years listed the presence of contaminants in fish or
contaminants and river pollution as the only reasons for not fishing the
river. Thus, contaminants appear to be the sole reason for dissuading a
substantial portion of currently-licensed anglers from fishing the Ohio River.
Awareness. An estimated 83% of anglers (adjusted for nonresponse bias) ^
who had fished the Ohio River in the past five years were aware of the health
advisories. Approximately two-thirds of this group said they were aware of
w
specific species or areas of the river listed in the advisories, whereas the
remainder were only generally or vaguely aware of the advisories. Younger
respondents (ages 15-29) and those with lower incomes were less likely to be
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aware of the specifics of the health advisories. Women were more likely than
men to be completely unaware of the health advisories. This is an important
finding because women, especially those of childbearing age, incur higher
potential risks if they eat contaminated fish, due to the possibility of
transferring contaminants and their effects to offspring. Anglers residing in
Kentucky, Indiana, and Ohio were most likely to be aware of specific advisory
recommendations. Over 85% of anglers from Illinois, where there is no health
advisory issued, said they were aware of the health advisories. This apparent
contradiction could be attributed to the fact that Kentucky (which borders the
Ohio River across from Illinois) and neighboring Indiana both have Ohio River
health advisories. Illinois respondents could be familiar with the KY and/or
IN advisories.
The most important source of health advisory information and the one
used most frequently by respondents (adjusted for nonresponse bias) was the
newspaper. Respondents who used the fishing regulations guide felt most
informed about the safety of eating fish (3.6 on a scale of 5); those using
friends felt the least informed (3.0). Although newspapers have been noted as
a frequently used and important source of information for respondents, when
asked about the best way to get information to them a plurality of respondents
(43%) said the television or radio would be best.
Beliefs. Most respondents (67%) disagreed with the statement that
eating-any fish from the Ohio River .is safe. Respondents were more likely to
believe that eating some types of Ohio River fish is safe, but a majority
X55%) either.did not,hold this belief or were unsure. Those fishing the
Illinois and Indiana portions of the river from Cannelton to the river mouth
were most likely to believe that eating some or any fish from the Ohio River
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was safe. Respondents who ate species listed in the advisories were also more
likely than other respondents to believe that eating some or any fish from the
Ohio River was safe. Respondents who were aware of advisory specifics were
more likely to believe that eating some types of fish was safe. *
Most respondents believed that eating Ohio River fish posed some health
risk for them. A majority of respondents believed that: (1) the health risks
are greater than the health benefits (56%); (2) eating contaminated fish over
many years increases their health risks (71%); and (3) Ohio River fish pose a
- health risk for them (58%).. .. ._.'._.,..
Attitudes. Most respondents were concerned that eating Ohio River fish
was a health risk (88%), and thought it was important to follow the health
advisories (71%). On average respondents felt somewhat informed about the g
safety of eating fish, and found it relatively easy to follow the advisory
recommendations. Those that were aware of advisory specifics felt more
informed and found it easier to comply with advisory recommendations than
those only generally aware of the advisory. v.
Behavioral Intentions. A plurality of respondents (45%) believed that
they follow the advice in the health advisories. Reported fish consumption
patterns for 91% of this group indicated they followed the advisory.
A majority of respondents (63%) would eat more Ohio River fish if health
risks did not exist. Fish consumption suppression (actual consumption lower k-
than desired consumption due to contaminants) therefore appears to exist among
Ohio'River anglers.
'Fishing Satisfactions. Consumption was more important for a satisfying
fishing experience for those eating listed species than for those who caught
but did not consume listed fish. This follows from our finding that those
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eating listed species were more likely to believe that following the advisory
would limit their enjoyment of fishing. For these respondents, consumption
appears to be an important part of the fishing experience, one perhaps not
easily given up.
Fish Consumption. Most respondents (95%) who fished the Ohio River in
the past year reported catching at least one fish from the river, but less
than half of the respondents (43%) ate any Ohio River fish. On average,
fish-consuming respondents ate 19 Ohio River fish meals annually. The most
popular fish species for both catch and consumption was channel catfish. In
fact, 92% of respondents who did not follow their state's advisory were
consuming channel catfish. Thus this species seems to be the most popular and
the one most often ignored based on the health advisory warnings.
Overall, 11% of respondents did not follow the recommendations of their
respective state's advisory. An additional 42% caught species listed in the
advisory but did not consume them in excess of the advisory recommendations;
the remaining respondents did not catch or consume listed species.
Respondents from Kentucky, especially those fishing near the Uniontown,
Newburgh, and Cannelton locks and dams, were two to three times more likely to
consume species listed in the advisory (primarily channel catfish) than other
anglers. Respondents who fished this section of the river most frequently
were more likely to hold a suite of beliefs and attitudes implying that they
did not believe that the risk existed.
Fish Preparation Methods. Thirty-five percent of Ohio River anglers
said they used all four risk-reducing cleaning techniques (remove back fat,
remove belly fat, remove skin, fillet fish) for all fish meals they prepared.
Most anglers use some of the risk-reducing cleaning techniques at least some
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of the time. Those fishing the lower stretches of the river most often were
also more likely to use risk-reducing cleaning techniques more frequently. + '
Among anglers consuming listed species beyond advisory limits, the majority
used risk-reducing cleaning techniques most of the time. \ *"
Use of risk-reducing cooking techniques was not prevalent, even among
consumers of listed species beyond advisory limits. More popular cooking
methods included generally non-risk-reducing methods such as pan frying or
I
deep frying.
Changes in Behavior as a Result of the Health Advisory. Among
respondents who were aware of the health advisories, 42% said they had reduced
their fish, consumption because of the advisory and 13% said they had stopped
consuming Ohio River fish altogether. Respondents who consumed listed species £:
beyond advisory limits were more likely than those who did not to say that
•because of the advisory they had changed their cleaning methods and were
eating less fish.
Relationship of Behavior to Attitude Activation. Very early in the ^
survey instrument used in this study, respondents who reported fishing on the
Ohio River within the past 5 years were asked to "list all information you
believe to be true about the safety of eating fish caught in the Ohio River"
and to "list specific actions you have taken related to the safety of eating
/»•<-
fish caught in the Ohio,River." Respondents in the spring reported L-
significantly more thoughts than in the fall (mean thoughts spring = 3.0; fall
= 2.6; t ='2.8; p <.01). Given that the health advisories were issued in the
spring just before the questionnaire was mailed, this trend was expected.
However, it does indicate that the advisories may be cognitively somewhat less •-
available by fall;
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Conclusions and Recommendations Regarding Health Advisory Impacts
Recommendations-for Agencies. Advisory awareness (as percent of
respondents aware of advisory) was lowest among anglers purchasing licenses in
states using mainly news releases to disseminate advisory information, and
highest in those states in which the health advisory is printed in the fishing
regulations guide. Although survey respondents did not choose the regulations
guide as being the most effective means of communication, they did feel most
informed about the safety of eating fish after reading the regulations guide.
States should consider the merits .of including health advisory information in
the fishing regulations guide, as well as in news releases to printed, audio,
and video media. Newspapers and posted warnings appeared to be particularly
important in urban areas.
Most respondents used some risk-reducing cleaning techniques at least
some of the time, .but adoption of -these methods was highest among respondents
eating listed species beyond advisory limits and among those listing a high
number of thoughts on the open-ended questions, the listed-species consumers
also appeared to be more committed to fish consumption as an important
lifestyle activity. Agencies should therefore consider emphasizing the
importance of using risk-reducing cleaning techniques especially if anglers do
not reduce fish consumption to recommended levels, because some anglers will
be unwilling to forego fish consumption altogether. Further, because
respondents listed more thoughts soon after advisories were issued than later
in the year, .advisory reminders later in the fishing season or posted at
fishing areas may help anglers think more about the advisories.
Although almost all respondents who fished the Ohio River in the past
year reported catching at least one fish, less than half ate any Ohio River
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fish. Such relatively low consumption by anglers may be of concern to
agencies whose objectives .include maintaining fish consumption at or slightly
below the levels recommended in the health advisory. Since the advisories
pertain to only a portion of Ohio River species, it is possible the fishery
resource is being underutilized in terms of human consumption. Only about 11%
of respondents did not follow the recommendations of their respective state's
advisory. In certain stretches of the River, however, noncompliance with the
advisory recommendations was considerably higher (e.g., Cannelton to
Uniontown), indicating targeted advisory communication efforts may be
warranted in these locales.
Among anglers eating listed species above the advisory limits, fish
consumption was an important component of a satisfying experience. These
anglers were also more likely to believe that following the advisory would
limit their enjoyment of fishing. For this group, warnings to reduce fish
consumption for health reasons may not be sufficient to stimulate compliance
with the advisory. Rather, behavioral alternatives that still allow this
important personal activity (fish consumption) to occur may be needed, such as
risk-reducing preparation techniques or emphasis on eating species not listed
in the advisory.
If state and regional agencies seek to emphasize the positive aspects of
Ohio River fish and fishing, catch-and-release fishing (already practiced by a
substantial portion of respondents) could be emphasized. Much more concerted
communication efforts would be needed to encourage consumption of the
harvestable fish species in the Ohio River that are not subject to advisories,
and would involve changing pervasive beliefs about the desirability and safety
of Ohio River fish consumption. -
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lOnly about one-third of survey respondents believed the advisory
provided them with enough information to make their own, informed, decision
about fish consumption. A substantial portion of respondents indicated they
felt they had insufficient information in the advisory to choose safer
alternatives (e.g., safer fishing locations, types or sizes of fish with less
contaminants, risk-reducing fish preparation methods). Although such
information can be included in detail in news releases, it is limited in
extent in the advisory news releases currently used by agencies. Further,
agencies have little control over what the media chooses to include in
articles or broadcasts stemming from the news release. The fishing
regulations guide provides a more certain vehicle for including detailed._
advice about contaminant levels at different locations, species and sizes of
fish less-affected by contaminants, and risk-reducing fish preparation
methods.
Recommendations for Research. The anglers from the Cannelton locks and
dam down to the river mouth were relatively different from other anglers in
terms of higher fish consumption, stronger beliefs that health risks do not
exist, and greater devotion to fish consumption as a part of the total fishing
experience. Future studies might target this river reach to understand
further the attitudinal, behavioral, and cultural factors influencing angler
response to health advisories.
This study demonstrated an association between the use of risk-reducing
cleaning techniques and lower levels.of personal concern about the health
risks, associated with consuming Ohio River fish. Future research could test
the hypothesis that anglers believe they do not have to follow the fish
consumption advice (I.e., number of fish meals per species) in health
xvi i
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advisories if they use risk-reducing cleaning techniques such as filleting the
fish or removing the fat. Testing this hypothesis is important for informed
risk management decisions. Some contaminants (e.g., mercury) are not reduced
through the use of such trimming techniques that reduce lipophilic compounds.
Anglers might think they are reducing their exposure when in fact they are
likely not.
A SUMMARY OF RISK COMMUNICATION CONCEPTS FOR COMMUNICATING HEALTH ADVISORIES
The third objective of this study was to summarize risk communication
issues agencies should consider when designing health advisory communication
programs for public audiences.
A Framework for Health Advisory Communication Programs
The Model. Health advisories are prepared, issued, and disseminated by
a variety of agencies and organizations, and are targeted toward a variety of
people—sport anglers, subsistence fishers, actual and potential fish
consumers, high-risk groups, and many different sociodemographic groups of
people. Sharing information, perceptions, and understanding among these
various participants is critical to successful health advisory communication
programs. - •' ~ .,...,..
We suggest using a model containing five elements to guide development
of health advisory communication programs: (1) problem analysis; (2) audience
needs assessment; (3) communication strategy design; (4) communication
strategy implementation; and (5) evaluation.
Problem Analysis: Objectives. Problem analysis includes consideration
of the social, scientific, and political context of the fish contaminant
issue, particularly specific articulation of the objectives to be accomplished
through a health advisory communication program. Objectives identified for
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health advisory communication programs include reducing human health risks,
encouraging informed decisions among potential and actual fish consumers,
fostering adoption of a variety of risk-reducing behaviors, encouraging
support for clean-up of toxics in the environment, encouraging enjoyment of
sport-fisheries, and informing people about the health and economic benefits
of fish consumption. Agencies, other organizations, and target audiences
should have a clear understanding of which objectives are to be achieved
through a health advisory communication program. Without such understanding,
it is virtually impossible to identify the "most appropriate" health advisory
recommendations and communication programs.
- Audience Needs Assessment. Audience needs assessment includes
identification of potential target audiences who should participate in the
health advisory communication program, and addresses what types of information
and communication styles are appropriate for each audience.
Identifying target audiences. Identification of potential target
audiences for health advisory communication programs should flow from the
objectives articulated during problem analysis, and may include audiences such
as licensed anglers, women of childbearing age, youth, urban anglers, or fish
consumers among the general public. To achieve a variety of objectives or
reach a variety of audiences, usually a variety of communication strategies is
needed. The information needs of these audiences and the communication
strategies used to convey that information may differ substantially.
^ i. Audience information and communication needs. Identifying the
information needs .and communication needs of the target audiences includes
understanding what the target audiences initially know and believe about
health advisories and fish consumption, how they behave relative to fish
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consumption, and what information they desire. Previous studies have
demonstrated that awareness of health advisories typically increases in a
given population over time, but tends to be lower among certain audiences
(e.g., women, youth, those with relatively low education or low income,
non-whites). Depending on the health advisory objectives, reaching such
low-awareness groups may take high priority for a communication program.
Perceptions of what is important to know about health advisories and
fish consumption may differ considerably between target audiences and "expert"
health advisory communicators. If communicators design communication programs
based solely on their own beliefs about what audiences should know, it is
likely audiences will not find the suite of information they believe they need
to-make an informed decision to follow or ignore the health advisory
recommendations.
Types of information identified by potential target audiences as
important for health advisories include: (1) specific comparisons of
relatively safer/more dangerous fish species, sizes, and fishing locations;
(2) description of negative health effects from eating fish; (3) health
benefits of eating fish; (4) specific comparisons of health risks from fish
consumption with other, particularly dietary, risks; (5) description of
risk-reducing fish cleaning and cooking methods; (6) description of chemicals
of concern and their effects. •
Audience behavior. Behaviors of interest include fishing and
fish-eating activities, as well as use of potential information sources (e.g.,
fishing regulations guides, newspapers, personal communications).
Understanding which information sources will be used by audiences to receive
health advisory information is critical in designing a communication strategy.
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r
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Understanding what behaviors fish consumers engage in is necessary in deciding
what current behaviors to reinforce or to change via health advisory messages.
Communication Strategy: Design and Implementation. Design and
implementation of the communication strategy involves constructing health
advisory recommendations appropriate to the needs of the target audiences, and
sharing these recommendations Busing dissemination mechanisms that will reach
each audience of concern.
Developing the advisory message. Depending on the target audience,
health advisories may include information such as: (1) a description of a
suite of risk-reducing behaviors beyond limiting or eliminating fish
consumption (e.g., fish cleaning and cooking techniques); (2) explanations of
how eating fish compares to other dietary risks; (3) description of the
negative and positive health effects associated with fish consumption, with
special emphasis on what groups of people are most endangered by or derive the
most benefit from sport-caught fish consumption; and (4) explanation of the
assumptions and uncertainty entering into the risk assessment-risk management
iprocess forming the basis for issuing health advisories. Decisions about what
information torinclude in any advisory should reflect the self-identified
needs of the target audiences as well as the objectives of the health advisory
program. .
Advisory dissemination mechanisms. Mechanisms by which potential fish
consumers receive rinformation about health advisories and contaminated fish
consumption include interpersonal sources (e.g., friends, government agency
professionals)^ mass mediar
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advisory recommendations has been associated with relatively high levels of
advisory awareness, knowledge, and compliance with recommendations. The
highest levels of health advisory knowledge have been associated with personal
communication with "experts" (i.e., professionals from state health and
fishery agencies). Other mechanisms accessible to many audiences of concern
include newspapers, television, posted warnings at access sites or in urban
areas, and specialized brochures distributed in areas used by the audiences of
concern (e.g., maternal health brochures in clinics and physicians' offices).
Timing of advisory dissemination. The results of this study showed that
advisory reminders throughout the fishing season may cause anglers to think
more about health advisories, and lead to compliance with advisory —
recommendations.
Evaluating the Communication Program. Evaluation includes measurement
of changes in knowledge, attitudes, and behavior among the audiences, as well
as assessment of how well original health advisory objectives were met. Two
basic types of evaluation are possible, formative and summative evaluations.
Formative evaluations of health advisory communication programs focus on
the process of communication, assessing whether the communication program is
being carried out as intended. Formative evaluation can be an ongoing process
of monitoring implementation of the health advisory communication program, and
can help identify necessary changes in program implementation.
Summative evaluations of health-advisory communication programs focus on
the outcomes produced through the communication process. Evaluators assess
whether vr not objectives were achieved, or whether outcomes were accomplished
that were prerequisite to objectives being achieved. Conducting summative
evaluations over time builds an evaluation information base that helps the
xxii
-------
communicator identify successes and areas needing improvement based on the
measurement trends.
During the formative or summative evaluation processes, new
communication issues or problems or previously unidentified audiences or
audience needs may surface. When this happens, the health advisory
communication program cycles back to the initial steps of the process, problem
analysis and audience needs assessment. Revised communication strategies may
result.
Summary
This and other studies of health advisory communication programs and
response by fish consumers shed light on the relationships between
information, knowledge, beliefs, and behavior. An important finding from each
of these studies is that fish consumers do not belong to a monotypical
audience. Variations in beliefs, behaviors, and abilities demand attention by
communicators to specific target audiences. Communicators can gather original
information specific to their local audience needs, or draw from the
information on audience trends documented in studies of anglers, fish
consumers, and health advisories conducted by the Human Dimensions Research
Unit and others. The result should be improved health advisory communication
programs, human health, and sport-fisheries.
xxm
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INTRODUCTION
Fish consumption health advisories have been issued in the United States
since the mid-1970's, and specifically in the Ohio River Valley since 1988, in
response to concern over potential negative health consequences of consuming
sport-caught fish. Some fish in the Ohio River have been found to contain
elevated levels of several contaminants, including PCBs and chlordane (ORSANCO
1991). Issuing health advisories with recommendations about limiting
consumption of fish and adopting other risk-reducing behaviors is the primary
management strategy being implemented by Ohio River Valley states to address
this problem (in addition to longer-term remediation and control activities).
Advisories issued by different states bordering the Ohio River have not
necessarily contained the same recommendations, even for the same stretch of
the River. For one large stretch of the River, one border state (KY) issues
an advisory which is disseminated via news releases, posted access points, and
the fishing regulations guide, whereas an adjoining border state (IL) issues
no advisory. Kentucky bases its reasoning for issuing an advisory on fish
tissue analysis for chemical contaminants collected thrpughout the Ohio River,
and on the premise that fish will not remain at one location over their
... ." . -. . ." • .
lifetime or even over a fishing season (J. Draper, Kentucky Dept. of Health
Services, personal communication, June, 1993). Based on an 18th century
agreement, KY has technical jurisdiction over the IL-KY stretch of the Ohio
River up to the high water mark; therefore, since IL does not have
- -,.. - " ~ " -: £-'. ; : --—*-. — - - - - ».-. •.., , . . -
-•_*+,; .._•,•- .
jurisdiction for the Ohio River, it issues no health advisory (T. Long,
-Illinois Dept. of Public Health, personal communication, June, 1993).
Proliferation of different advisories and communication strategies raises
questions about the impacts one or multiple advisories are having on the
audiences of interest. Further, differences among agencies regarding
-------
2
objectives they seek to accomplish v.ia health advisories may contribute to the
differences in approaches used to develop and communicate advisories with the
public (Knuth 1989, 1990; Knuth and Connelly 1991).
Evaluations of health advisory communication efforts have focused
largely on whether anglers are aware of advisories, and have measured whether
anglers have changed their fishing or fish consumption habits as a result of
the advisory (Connelly et al. 1990; Fiore et al. 1989; Springer 1990).
Connelly at al. (1990) and Springer (1990) assessed what types of information
could lead to improved advisories from
-------
3
hope to accomplish with health advisories, and the attention they devote to
creating, disseminating, and evaluating advisories (Knuth 1989; Knuth and
Connelly 1991).
Strategies for disseminating health advisories vary among agencies. In
some regions (e.g., Great Lakes), agencies commonly include the health
advisory information as part of the fishing regulations guide distributed to
anglers at the point of license purchase. In other regions, including the
Ohio River Valley, the use of press releases at one or more key points in time
is a primary advisory dissemination mechanism. To our knowledge, no one has
yet tested empirically the question of timing of health advisories, -
particularly in situations in which advisories are not included in the fishing
regulations guide but rather are publicized through intermittent or
one-time-only news releases. Timing of the advisory news releases could be
important if the impacts from the advisories (e.g., anglers attitudes,
behaviors) are greatest shortly after media attention and then diminish over
time as media attention fades.
The Ohio River Valley provides a useful setting for examining timing and
type of dissemination mechanism. The five states issuing advisories
coordinate their annual spring news releases (A. Vicory, ORSANCO, personal
communication, October, 1991), with some states (PA, WV) relying on these
releases as the primary mechanism for disseminating advisory information. A
few states {IN, KY, OH) also include the advisory information within the state
fishing regulations guide. (Pennsylvania began including the health advisory
in its fishing regulations guide in December, 1992, after the data-gathering
phase of this study'had been completed [R. Frey, PA Bureau of Water Quality
Management, personal communication, June, 1993.]) One state (KY) posts
-------
4
advisory -information at each of its Ohio Riyer access sites. One state (IL)
has no Ohio River advisory, but lists other state waters with advisories
within the state fishing regulations guide.
Objectives
The objectives of this study were to:
(1) identify state and regional agency objectives associated with (f
state fish consumption health advisories in the Ohio River Valley;
(2) determine the impacts associated with Ohio River health advisories
including (a) awareness of, attitudes, and opinions about health
advisories held by Ohio River Valley anglers; (b) angler
.. '- • ....-.--. - .. . '. - . Q
behavioral changes associated with advisories; and (c) effect of
urban vs. rural residence, and recent vs. distant media attention
relative to advisory awareness and behavior; and
(3) summarize risk communication issues to consider when communicating
health advisories to the public.
This report is arranged into three major sections, one addressing each
of the project objectives.
.-_.*•/ t'" .."- "",-..-"
Conceptual Background ;
f'
Two major theoretical frameworks and the empirical studies listed *-
earlier provided the conceptual underpinnings for this study. Because the
relationship between attitudes and behaviors is complex, both must be measured
to evaluate.the impacts of health advisories on anglers. The theory of
planned behavior (Ajzen and Fishbein 1980; Ajzen 1989) provided the basis for
an overall predictive and analytical model that guided research instrument
development and analysis (Fig. 1). This theory holds that behavior is a
-------
•8
I
*
Information Sources Used
P3
Beliefs About
"Following Advisory
Evaluation of
Fish Consumption
Outcomes
Normative Beliefs
About Following
the Advisory
(not assessed)
Motivation to
Comply with
Important Others
1
1
1
Attitude
Toward
Fish Consumption
Intention to
Consume Fish
(not assessed)
Perceived
Control Over
Fish Consumption
Outcomes
Fish Consumption
Behaviors
-• Listed Species
Consumption
• Use Risk-reducing
Cleaning Methods
Figure 1. Conceptual diagram of social-psychological process determining
response to health advisories, derived from the Theory of Planned
Behavior (Ajzen 1989), and modified from Connelly et al. (1992).
-------
I
6
result of several determinants, including a set of external variables, and a
host of beliefs and attitudes. Connelly et al. (1992) used this theory to
demonstrate that behavioral responses of potential fish consumers to
recommendations in health advisories are a function of a set of external
variables, beliefs, and attitudes. We operationalized each of these concepts
in this study, although some more completely than others.
£
The theory of attitude activation (Fazio 1986; Shapiro 1991) guided our
assessment of the effects of recent exposure to health advisory information on
angler attitudes and behaviors. This theory holds that people have existing
attitudes that can be activated (e.g., by media attention) to stimulate action
(behavior). The importance of this approach is that it could help answer the ~
question of when to activate an attitude for the most impact, i.e., when best
to remind people of health advisory recommendations to result in the greatest
adoption of risk-reducing behaviors.
The following sections describe the series of variables we measured, ^
including external variables, beliefs and attitudes, and behaviors.
External. Variables
Attitudinal and behavioral responses to health advisories may be
influenced by several external variables. We included variables measuring
f-
socio-demographic characteristics of licensed anglers, the information sources »—
they used to learn about health advisories, and their basic awareness of the
advisories and knowledge about fish consumption-related issues, because these
variables have been shown to influence attitudes and behaviors (Knuth 1990;
Connelly et al. 1992; Connelly and Knuth 1993). Demographic and
^c-.
information-source variables may also be used to identify potential target
audiences if health or fishery management agencies seek to develop a
-------
7
communication program for specific groups of potential fish consumers.
Variables measuring awareness, with the potential to influence behavior, were
included because of the importance of agency objectives related to allowing
people to make their own, informed decision about eating sport-caught fish
(Knuth and Connelly 1991).
Beliefs and Attitudes
We measured several cognitive and affective factors with the potential
to influence fish consumption-related behavior. These factors included:
beliefs and attitudes about following the advisory; beliefs about the likely
outcomes associated with following the advisory or eating sport-caught fish;
beliefs and attitudes about an individual's ability to control their own
• '"•'•••
behavior or risk level; and normative factors, such as the influence of other
people's attitudes on a given angler's behavior. General beliefs and
attitudes that may affect behavior have been described by Ajzen and Fishbein
(1980) and Ajzen (1989). Connelly et al. (1992), Connelly and Knuth (1993),
and Diana et al. (1993) demonstrated the importance of beliefs and attitudes
in influencing fish consumption-related behaviors, particularly those related
to advisory knowledge, beliefs about health risk, and perceived control over
the potential health risk.
Behaviors
We measured a suite of behaviors related to sport-caught fish
consumption, including days fished on the Ohio River, number of meals of Ohio
River fish eaten, consumption of species listed in the health advisories, and
use of risk-reducing fish cleaning and cooking procedures. Many of the
•' • '>•••:": - : " .''£•:', »'•'- ' . . ' . •
primary objectives held by agencies involved in health advisory programs focus
on fostering multiple behaviors that result in reduced human health risk, not
-------
8
just limiting or eliminating consumption of certain species of fish (Knuth and
Connelly 1991).
AGENCY OBJECTIVES ASSOCIATED WITH OHIO RIVER HEALTH ADVISORIES
Our first objective was to identify state and regional agency objectives
associated with state fish consumption health advisories in the Ohio River
ff
Valley.
Methods
We conducted telephone interviews with two or three individuals in each
state who had major responsibilities associated with health advisories. We
chose one representative from each state health, environmental quality, and
fishery management agency, as appropriate. We also interviewed one
representative from the Ohio River Valley Water Sanitation Commission
(ORSANCO), a regional agency involved in coordinating and conducting water
quality-related research and management activities in the Ohio River Basin.
State personnel from each agency type were those defined by the agency as
having chief responsibility for the health advisory program. Interviewees
held a variety of administrative and technical responsibilities within the
agencies. . - ' ^"
Each telephone interview focused on perceived agency health advisory
objectives and opinions about criteria for evaluating the success of health
advisories. Telephone interviews were conducted in May and June, 1991 for IL,
~IN, OH, and PA, and'in March and April, 1992 for KY, WV, and ORSANCO. We made
an initial call and up to four call-backs if the initial and subsequent
contacts were inconvenient for the agency representative. If the individual
indicated s/he no longer had health advisory responsibilities, we obtained the
L
-------
9
name of the replacement and contacted that person. The interview lasted about
15 minutes and included closed- and open-ended questions.
Results and Discussion: Health Advisory Objectives and Evaluation Criteria
We completed 15 telephone interviews with 5 fishery agency
representatives, 5 health agency representatives, 4 environmental quality
agency representatives, and 1 ORSANCO representative.
Health Advisory Objectives
Of 20 potential objectives presented to agency representatives, the most
important objectives for states overall included those focused on: (1)
reducing health risks for particularly at-risk groups, the general public,
licensed anglers, and subsistence fishers; and (2) helping people make their
own informed decision about cleaning, cooking, and eating Ohio River fish
(Table 1). Each of the five states issuing Ohio River health advisories (IN,
KY, OH, PA, WV) include specific fish preparation guidance in their health
advisories. .
Objectives of moderate importance overall included those related to
motivating people to become involved in Ohio River clean-up activities.
Objectives of lowest importance included those focused on: (1) informing
people about the health benefits of eating fish, (2) encouraging uses of
sport-fishery resources, and (3) protecting local economies. Although these
last objectives were of relatively low importance overall, about one-fourth of
respondents judged each of these three objectives to be very important or
extremely Important (Table 1), indicating differences in health advisory
program objectives among agency personnel.
We performed a factor analysis to examine the underlying relationships
between objectives and reduce the large set of objectives to a smaller set of
-------
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13
factors accounting for the observed interrelationships in the data. We used a
principal axis factoring procedure with varimax rotation (SPSS Inc. 1986).
Three objectives were dropped from the analysis to improve reliability and the
percent of variance explained (i.e., meet legal mandates of government
agencies, inform people about health benefits from eating fish, discourage
people from eating fish). The factor analysis explained 85.1% of the variance
in the data. We assigned meaning to the four factors identified based on the
types of objectives with the highest factor loadings on each factor (Table 2)
as follows: public support and resource use; health risk reduction; risk
reducing fish preparation methods; and informed individual decisions.
We performed a cluster analysis to group individual respondents into
clusters based on their mean factor scores (SPSS Inc. 1986). Two clusters
resulted. A majority (9/10) of health and environmental quality personnel
(state and regional) grouped in one cluster; a majority (3/5) of fishery
personnel grouped in the other cluster. As in the Great Lakes states (Knuth
and Connelly 1991), differences exist in the importance placed on potential
health advisory objectives by fishery and health/environmental quality
agencies. Fishery agencies placed greater emphasis than the environmental
quality agencies on objectives associated with public support and resource
use, risk-reducing fish preparation methods, and enabling people to make their
own informed decisions about fish consumption. No pattern of state-to-state
differences was observed in the cluster analysis results.
Health Advisory Evaluation Criteria
Nineteen potential health advisory evaluation criteria were presented to
agency representatives. The most important criteria identified included: (1)
advisory awareness: (2) use of risk-reducing fish preparation methods; (3) use
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of fishing behaviors (i.e., species targeted, size kept); and (4) fish
consumption rates at or slightly below advisory recommendations (Table 3).
These evaluation criteria correspond to several of the highest-priority
objectives noted above, specifically helping people make their own, informed
decision, and reducing health risks. Evaluation criteria focused on fish
consumption by children and women of childbearing age were rated slightly more _
i
important than those related to fish consumption by anglers in general,
reflecting the highest-priority objective to reduce health risks to
particularly at-risk groups of people. Two Ohio River states' (IN, KY)
advisories include special recommendations for women of childbearing age and
children. Lowest importance was assigned to evaluation criteria related to c
fishing activity and fishing license sales (Table 3).
We performed a factor analysis to examine the underlying relationships
between evaluation criteria and reduce the large set of criteria to a smaller
set of factors accounting for the observed interrelationships in the data. We c
used a principal axis factoring procedure with varimax rotation (SPSS Inc.
1986). One evaluation criterion was dropped from the analysis to improve
reliability and the percent of variance explained (i.e., advisory awareness
among general public). The factor analysis explained 83.1% of the variance in
the data. We assigned meaning to the three factors identified based on the *"••
types of evaluation criteria with the highest factor loadings on each factor
(Table 4) as follows: angler awareness and recommended consumption, angler
behavior, and consumption far below advisory level.
We performed a cluster analysis to group individual respondents into
clusters based on their mean factor scores (SPSS Inc. 1986). Two clusters
resulted. A majority (7/9) of health and environmental quality personnel
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-------
22
(state and regional) grouped in one cluster; a majority (3/5) of fishery
personnel grouped in the other cluster. As with the rating of objectives
(discussed above), differences exist between fishery and health/environmental
quality agencies in the importance placed on potential health advisory
evaluation criteria. Fishery agencies assigned greater importance than
environmental agencies to evaluation criteria associated with angler behavior
and angler awareness. No pattern of state-to-state differences was observed
in the cluster analysis results.
IMPACTS OF OHIO RIVER HEALTH ADVISORIES
The second objective of this study was to determine the impacts
associated with Ohio River health advisories, including (1) awareness of,
attitudes, and opinions about health advisories held by Ohio River Valley
anglers; (2) angler behavioral changes associated with advisories; and (3)
effect of urban vs. rural residence, and recent vs. distant media attention
relative to advisory awareness and behavior.
Methods : -
Hail Surveys -: ~ - _. -
We implemented two mail surveys, one each in Spring and Fall, 1992, to
assess the effect of timing of advisory communications on health advisory
awareness and attitudes. Samples of 2,000 resident licensed anglers for the
spring survey and 3,000 resident licensed anglers for the fall survey were
obtained from the six states that border the Ohio River (Fig. 2). For the
.,,...-...- .
spring survey, 1,000 nalnes were taken from licenses sold in Metropolitan
Statistical Areas (MSA) counties (urban) and 1,000 from licenses sold in
-non-MSA counties (rural). (See Appendix Table A-l for a listing of the
-------
23
I
2
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-------
24
counties.) The number of names sampled in each county was determined by the
proportion of miles of Ohio River shoreline in that county. The purpose of
this sampling strategy was to ensure a distribution of respondents along the
river and a large enough sample size in both urban and rural areas to allow
comparisons between them regarding health advisory awareness, sources of
information, and other variables. The purpose of the sampling strategy for
the fall survey was to obtain a sufficient sample size in each state so that
statistical tests could be used to compare respondents from each state.
Originally, 500 names were "to be drawn from each state. However, the
number of licenses available to be sampled.in Pennsylvania and Illinois was
relatively small. Only 300 names were taken from each of these states with
the remaining 400 names taken equally from among the remaining states. We
anticipated that when the respondents from the spring and fall surveys were
combined the sample size in the smaller states would be sufficient for
statistical analysis. Names were drawn from each county in approximate
proportion to the number of licenses sold in each county.
Any license that permitted resident fishing (i.e., resident annual,
resident short-term) in 1991 was considered for inclusion in the sample (in
Pennsylvania, 1990 licenses had to be used). To increase the chances of
contacting anglers who fished the Ohio River, sampling was limited to counties
bordering the river. Because Ohio, Indiana, and Illinois do not require that
license records be returned to a central location, -a cluster sampling approach
'
was needed, which involved traveling to counties bordering the Ohio River and
drawing the sample from records at license sale outlets. A list of agents
selling licenses in counties -bordering the Ohio River was obtained for each
state. A sample of agents was contacted and permission obtained to draw a
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25
sample from their 1991 records. For^Pennsylvania, West Virginia, and Kentucky
the licenses were returned to a central location and thus the entire license
.pool from each county could be :used in selecting the sample.
,..-a i.rWe .used the results from the telephone interviews with agency personnel
(discussed previously), and findings from other studies, to develop a mail
questionnaire to be sent to the sample of licensed anglers. The questionnaire
was designed to determine the awareness of, attitudes and opinions about, and
behavioral responses to current Ohio River health advisories as well as
identify potential improvements to the advisories from the perspective of Ohio
River Valley anslers. The questionnaire was reviewed by staff from Cornell
University^ USEPA, and ORSANCO. Slight modifications were made to the fall
questionnaire after the spring survey was implemented. (See Appendix B for
exact content .and wording .of both questionnaires.)
;; The spring survey was implemented in late April, 1992 and the fall
survey in late September, 1992. Up to three follow-up mailings were sent to
nonrespondents over the course of the following months. Returned
questionnaires were coded and entered onto the computer using the SPSS Data
Entry II software package. •
Nonresoondent Follow-up
A telephone follow-up to 151 nonrespondents to the spring survey was
conducted.in June, 1992 and another one to 100 nonrespondents to the fall
•survey in November^ 1992 /to pro vide, an estimate of the degree to which
nonrespondents to the mail surveys differed from respondents. Previous
research, showed.that nonrespondents fish much less than respondents and are
less .likely to be aware of health advisories (Brown and Wilkins 1978, .Connelly
€t;al, 1990, Connelly et al. 1992). Nonrespondents who were contacted by
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:26
"telephone were considered to be representative of all nonrespondents. When
respondents to the fall and spring surveys were similar, the results of the
nonrespondent/respondent comparisons were pooled to increase the sample size.
Thus differences that might not have been significant for the fall or spring
survey were significant in the pooled sample.
'Statistical Analysis ' - r
Analysis was done using the SPSSX computer program (SPSS Inc. 1986).
Chi-square, t-tests, and Scheffe's test were used to test for statistically
significant differences at the P < .05 level. Principal components factor
analysis with varimax rotation and tests of reliability (Cronbach's alpha)
were used to create several scales. Path analysis, a form of causal analysis, c
was used to test the strength of the relationships hypothesized in Fig. 1.
Path analysis involves conducting a series of ordinary least squares
regressions on each dependent variable in the causal diagram (Blalock 1985).
The standardized regression coefficients provide a comparable measure of the c:
strength of each hypothesized relationship.
During the printing of the spring questionnaire, 8% of the
questionnaires were assembled improperly so that one page was out of order.
Before analysis of the data was undertaken comparisons were made between
r**
respondents whose questionnaires had pages in the correct order and those *~
whose questionnaires did not. A significant difference was found for three
variables, so these-variables from the Incorrectly-ordered questionnaires were
dropped-from further analysis.
* The fall questionnaire included an experiment with question order
performed as part of'a regional research methods project in which the Human
Dimensions Research Unit (HORU) is involved (Brown 1991): Analysis showed no
-------
27
difference In the results based on change In question order, so no adjustments
were made to the data to compensate for this experiment.
Using respondents' reported Ohio River fish catch and consumption by
species, a classification system of Ohio River fish consumption based on
respondents' adherence to health advisory recommendations was created. Since
recommendations for consumption vary by state, the state of license purchase
was used to determine the applicable health advice for each individual. A
respondent was placed in the most restrictive consumption group possible. The
definition of each group is outlined below:
1. "Neither Caught Nor Consumed Listed Fish". The respondent did not
-catch or eat any of the species listed as unsafe in the health
advisory for their state of license purchase.
2. "Caught But Did Not Consume Listed Fish Above Recommended Limits".
The respondent caught listed fish but did not eat them in excess
of the limits recommended in the health advisory.
3. "Consumed Listed Fish Above Recommended Limits". The respondent
ate at least .one meal of listed fish in excess of the limits
recommended in the health advisory.
Classification of respondents into these consumption categories was
based on their reported behavior compared with the health advisory in effect
at the time of the surveys. Briefly, the Ohio River health advisories were
generally as -follows (all state advisories also included recommendations for
risk-reducing .fish cleaning and cooking techniques)::
IL: No advisory for Ohio River fish. Therefore, IL anglers were not
grouped into consumption categories 2 and 3 above.
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28
IN: Advisory recommended no consumption of Ohio River channel catfish
greater than 19" length; no consumption of any channel catfish or
carp for women of childbearing age; no more than 1 meal/week of
channel catfish less than 19" or carp for adult men and women not
of childbearing age. We did not collect data on length of fish
consumed; therefore, channel catfish consumption was treated as
category 3 (exceeding advisory limit) only if it exceeded 52
meals/year for men and women not of childbearing age, or if any
channel catfish consumption occurred for women of childbearing
-— age.
KY: Advisory recommended no consumption of Ohio River channel catfish,
carp, white bass, paddlefish, and paddlefish eggs. Any
consumption of these species was treated as category 3 above.
OH: Until Spring, 1992, the advisory recommended no consumption of
channel catfish and carp caught near lock and dam areas from
Greenup upstream, and no consumption of channel catfish and white
bass from the Mill Creek area in Cincinnati. After Spring, 1992,
the advisory recommended no consumption of channel catfish and
carp from the entire river (pools and dams) from Greenup dam
upstream. Because the fishing location data available from the
survey was limited to the name of the lock and dam closest to the
river reach fished, we treated any consumption of channel catfish
and carp from Greenup upstream as category-3 above. We could not
identify consumption of fish from an area as specific as Mill
Creek.
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29
PA: Advisory recommended no consumption of carp from the Ohio River,
and no consumption of channel catfish from Montgomery and
. Dashields locks and dams areas. We treated as category 3 above
'-••- any carp consumption, and any consumption .of channel catfish if
the area most frequently fished was either of these two darts.
WV: " Advisory included channel catfish and carp from the Ohio River.
Any consumption of these species was treated as category 3 above.
Results and Discussion: Health Advisory Impacts
->?•*•"" .-.-••
Survey Response
For the spring survey, of the 2,000 questionnaires mailed, 142 were
undeliverable and 841 completed questionnaires were returned. This resulted
in an adjusted response rate of 45.3%. The response rate was higher in urban
(MSA) counties than rural (non-MSA) counties (Table 5). For the fall survey,
of the 3,000 questionnaires mailed, 262 were undeliverable and 1,269 completed
questionnaires were returned. This resulted in an adjusted response rate of
46.3%. Response rate differed by state of license purchase with Kentucky
being the highest and Illinois and West Virginia the lowest (Table 5).
Adjustments for Nonresoonse Bias
Results of npnresponse bias comparisons confirm the conclusions of
previous research (Brown and Wilkins 1978; Connelly et al. 1990, 1992) that
nonrespondents fish less than respondents and are less likely to be aware of
health advisories (see Appendix C). Fishing activity at locks and dams was
higher among respondents than nonrespondents for the spring survey, and higher
""''"..,• *•"*•". ' '" '! - ! "•' -.--.-'. • , -, •' • ,
among respondents than nonrespondents for fishing activity in pools between
dams for the fall survey.
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30
Table B. Response rates for-fall and spring surveys.
Spring '92
Urban
Rural
Fall '92
Pennsylvania
West Virginia
Ohio
Indiana .
Kentucky
Illinois
TOTAL
Initial
Sample Size
2000
1000
1000
3000
300
600
600
600
600
300
5000
Undeliverables
142 .
85
57
262
31
47
74
45
47
18
404
Adjusted
Sample Size
1858
915
943
2738
269
553
526
555
553
282
4596
Compl eted
Returns
841*
437
402
1269**
123
233
250
265
278
119
2110***
Response
Rate
45.3
47.8
42.6
46.3
45.7
42.1
47.5
47.7
50.3
42.2
45.9
*Includes 2 responses for which the ID# was removed, so residence area could
not be determined.
**Includes 1 response for which the ID# was removed, so state of purchase
could not be determined.
***Includes 3 responses for which the ID# was removed, so residence area or
state of purchase could not be determined.
Respondents were more likely to use a variety of sources to obtain
health advisory information compared to nonrespondents. These sources
included newspapers, magazines, fishing regulations guides, and friends. In
the spring survey, respondents were more likely than nonrespondents to list
Ohio River contaminants as a reason for not fishing the Ohio River.
Respondents to the spring and fall surveys were more likely than
nonrespondents to say they had taken fewer fishing trips to the Ohio River
because of the health advisories, but the two groups did not differ in the
percentage who had fished the Ohio River in the past five years. Based on
past research, we expected that nonrespondents would have been more likely not
to have fished the Ohio River, accounting for their nonresponse. However, our
-------
follow-up mailings to slow responders stressed the importance of responding
even if an angler had not 'fished the Ohio River, and emphasized the ease with
which an angler could respond if s/he had not fished (i.e., they only had to
:answer a few questions). Stressing those points in the reminder mailings may
account for the lack of expected difference between respondents and
nonrespondents for this variable. Respondents and nonrespondents did not
differ in their attitudes toward safety or risk involved with Ohio River fish
consumption, or in socio-demographic characteristics; (Detailed comparisons
can be found in Appendix C.)
_„. We made adjustments for..nonresponse bias to population-level estimates
for the variables: awareness of the health advisory and sources of health
advisory information (detailed in Appendix C). These results are presented
later in the sections of'the report where health advisory awareness and
: information sources are discussed in detail.
Determining the Population
In this study, we sought to contact people with Ohio River fishing
experience. -However, it was neither practical nor economically feasible to
conduct a creel survey and draw a sample of only those anglers who had fished
the Ohio River. Thus, some anglers with no knowledge or experience on the
Ohio River were included in the sample using the license record method
outlined above. It is also possible that some anglers had dropped out of Ohio
River:?fishing because of contaminants, and we sought to determine the extent
to which that occurred; To more clearly'identify these two populations, we
defined "Ohio River experience" as including only those respondents who had
fished the Ohio River in the past five years or had eaten Ohio River fish in
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32
the past year. Respondents who had no Ohio River fishing experience accounted
for 38% of our spring sample and 44% of our fall sample.
We discuss briefly the characteristics of this group and reasons for not
fishing the Ohio River below. However, the majority of the report focuses on
respondents who had fished the Ohio River in the past five years or eaten Ohio
River fish in the past year (62% of spring, 56% of fall respondents). Very
few respondents (1%) ate Ohio River fish but did not actually fish the Ohio
River; for simplicity we refer to this entire group as respondents who fished
the Ohio River in the past five years.
Respondents Who Had Not Fished The Ohio River In The Past Five Years
These respondents were more likely to be older anglers and/or women than
respondents who had fished the Ohio River in the past five years (detailed
socio-demographic comparisons can be found in tables in Appendix D). The
phenomenon of not fishing the Ohio River was greater among respondents living
in Pennsylvania or Indiana, implying that anglers who live in counties
bordering the river in PA and IN are less likely to fish the Ohio River than
anglers in border counties in other states (Appendix Table D-l).
The majority of respondents did not fish the Ohio River because they
preferred other locations or because they would not want to eat the fish due
to contaminants (Table 6). Additionally, many respondents did not fish the
river because they believed it is too polluted. For women and residents of
Indiana (who were more likely to have not fished the Ohio River),.the reason
checked most frequently was that they would not want to eat the fish due to
contaminants (Appendix Table D-2). Middle-aged respondents (ages 30-49) and
* j
residents of Kentucky and Ohio were also more likely to be concerned about
contaminants and-pollution than other respondents. For the oldest group of
r
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33
Table 6. For those who have not fished the Ohio River in the past five
years, percent of respondents checking various reasons for why
they have not fished the Ohio River in the past five years.
Respondents could check more than one reason.
-Reasons for not fishing the Ohio River ,:...--.-.
in the oast five years Percent
Prefer to fish other locations 58.9
Due to contaminants, wouldn't want to eat the fish 58.7
Believe the Ohio River is too polluted to fish in* 46.7
Don't have the necessary boat or equipment 27.9
Don't think the Ohio River has good fishing opportunities 6.9
Not interested in types of fish available 4.7
Not interested in sizes of fish available 1.7
Other 12.0
"Question asked only in the fall survey.
respondents and Pennsylvania residents (also more likely not to have fished
the Ohio River), concern about contaminants was checked less frequently than
by other respondents. Respondents from Illinois (where no health advisory
exists) were far less likely to indicate that contaminants or pollution were
reasons for not fishing the river, although these were important reasons for
about one-third of Illinois respondents. .
'-Respondents could check as-manytreasons for not.fishing as they wished.
Nineteen percent of respondents who-had not fished the Ohio River in the past
jfive years listed the presence of contaminants in fish or contaminants and
river pollution as'the only reasons for not fishing the river. Thus, ,^
^contaminants appear to be the sole reason for dissuading a substantial portion
of currently-licensed anglers from fishing the Ohio^River. We do not have
information about potential anglers who have not purchased a fishing license
due to concerns about contaminants.,; ; : =
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•34
Respondents Who Fished The Ohio River In The Past Five Years
Using the model developed from the Theory of Planned Behavior as a
guide, the following sections focus first on the external variables of socio-
demographic characteristics, information sources, and advisory awareness, then
address issues of beliefs and behaviors (Fig. 1).
External Variables [JF
Awareness. An estimated 83% of anglers (adjusted for nonresponse bias)
who had fished the Ohio River in the past five years were aware of the health
advisories. Approximately two-thirds of this group said they were aware of
specific species or areas of the river listed in the advisories, whereas the
C
remainder were only generally or vaguely aware of the advisories. As in other
studies of health advisories (Connelly et a!., 1990, 1992, 1993), awareness
differed by socio-demographic characteristics. Younger respondents (ages
15-29) and those with lower incomes were less likely to.be aware of the
specifics of the health advisories (Table 7). Women were more likely than men
to be completely unaware of the health advisories. This is an important
finding because women,, especially those of childbearing age, incur higher
potential risks if they eat contaminated fish, due to the possibility of
transferring contaminants and their effects to offspring. r~-
Li-
State of residence was related to advisory awareness. Anglers residing
in Kentucky, Indiana, and Ohio were most likely to be aware of specific
advisory recommendations. At the time of this study, these three states were
the only Ohio River states to publish their Ohio River advisory in the state
.»-
fishing regulations guide in addition to using news releases. Kentucky also
uses posted warnings at Ohio River access sites. Anglers residing in
Pennsylvania were either aware of the specifics or not aware at all compared
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~35
Table 7- For respondents who fished the Ohio River in the past five years,
percent who were aware of the health advisories-overall, by socio-
demographic characteristics, state of residence, and time of survey.
Aware of Health Advisories
-";.'- . - . . ' • ' ' ': 7
Overall
Age
15-29
30-39
40-49
50+
Education
-Grades 1-11 ..,_
Grad. High School
Some College ........
Grad. College
Some Post Grad.
Income
< $20,000
$21,000-$34,000
$35,000-$50,000
> $51,000
Sex •• ••' ; '- •-<•-•. v ••"-. ' •• •
Male
Female -.."• «.;..».
Race .; •
White
Other •-•
Residence Area : -
Urban
Rural •::-. : - -*••,-,
State :of Residence .-. ; ;•; ?•-• .L.
Pennsylvania
West Virginia ,.- .:•-
Kentucky
-Illinois ^ , :-.-- :
Indiana
••Oh10-.';v--.f-j r- .-.,• ,:••.-.; ;.;;,
Time of Survey, c •" ;
Spring '92
Fall '92
• " '- •
No
13.1
'
19.2
14.4
10.6
8.1
11.3
14.7
13.1
14.8
6.8
15.5
13.0
11.1
11.3
•
11.4
;~t, 22.8
:-',-.-•••
12.8
• , . 24.4
13.5
<•: 12.8
--T~ ', ; • -'-.- - -
"20.7
n:H r , 19.6
7.7
- 12.6
10.3
v^.:.'i:W- •.-;•- 13.8
•. ~ • • -•... • - • -••
13.1
13.1
Generally
Aware
Percent
33.2
46.7
34.4
26.0
25.5
30.6
30.5
38.1
37.0
24.7
34.7
36.9
34.4
23.3
33.4
32.8
33.4
34.1
33.0
34.0
25.9
35.2
30.7
42.3
34.2
31.2
34.5
32.3
Aware 4>f
Specifics
53.7
34.1*
51.2
63.4
66.4
58.1
54.8"
48.8
48.2
68.5
49.8*
50.1
54.5
65.4
55.2*
44.4
53.8
41.5
53.5
53.2
53.4*
45.2
61.6
45.1
55.5
55.0
52.4
54.6
*Statistically significant difference between groups at P < .05 using Chi-
square test.
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36
with anglers from other states. At the time of this study, Pennsylvania and
Nest Virginia relied primarily on news releases to disseminate the health
advisory recommendations. Over 85% of anglers from Illinois, where there is
no health advisory issued, said they were aware of the health advisories.
This apparent contradiction could be attributed to the fact that Kentucky
(which borders the Ohio River across from Illinois) and neighboring Indiana
both have Ohio River health advisories. Illinois respondents could be
familiar with the KY and/or IN advisories.
Advisory awareness did not differ by urban versus rural residence. We
hypothesized that awareness would be higher in the spring than in the fall,
following the annual spring surge of media attention, but advisory awareness -F
-L
did not differ based on timing of the survey. Additionally, responses
regarding how recently an angler had read or heard about the safety of eating
Ohio River fish did not differ between the spring and fall surveys.
Sources of Information. The most important source of information and
the one used most frequently by respondents (adjusted for nonresponse bias)
was the newspaper (Table 8). It is the source whose use is correlated most
highly with advisory awareness. Those using the newspaper as a source of
information were more likely older, had higher incomes, and attained a higher
level of education than those not using the newspaper (Appendix Table D-3). ^
Path analysis indicated that age and income are the two significant predictors
of use of newspapers (Fig. 3, Table 9). (Education was not included in this
analysis because of its high correlation with income.)
Mentioned less frequently as sources of information, but still used by a
plurality of respondents (adjusted for nonresponse bias) were television or ""
radio and friends (Table 8). Friends were mentioned more frequently and
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37
Table 8. The percent of respondents using each source of health advisory
information and the mean importance of that source.
Information Sources Used to
Learn About Health Advisories
Percent
Checked8
Respondents
Adjusted for
Nonresponse
Bias
Mean
Importance1*
Newspaper article or editorial
Television or radio
Friends
Fishing regulations guide
Magazine article
Warnings posted at fishing sites
Newsletters from fishing clubs
Health advice brochures from
government agencies "
Charterboat operators or guides
Newsletters from environmental
interest groups
Personal physician
70.2
60.1
51.8
- 21.6
16.7
10.3
4.1
~ ;2.8
2.1
___
— — —
63.0
NS
37.6
14.5
12.1
NS
3.5
3.2
3.1
3.1
2.6
2.8
2.1
2.2
1.8
2.2
2.0
Question asked only on the spring survey. Newsletters and physician were not
included on the list in this questionnaire. Percents add to more than 100%
because more than 1 source of information could be checked.
Question asked only on the fall survey. Importance was measured on a scale
where 1 = not at all important to 5 = extremely important.
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38
00
o>
1
I
H
.154*
Used Newspaper As A
Source of Advisory
Information
.159*
Advisory
Awareness
Figure 3. Path diagram of relationships between external variables, with
standardized regression coefficients from an ordinary least
squares regression. Asterisks indicate significant values (p =
.05).
Table 9. Angler path analysis regression results for Fig. 3.
Dependent Adjusted
Vari abl e R-square
advisory awareness ;053
newspaper as a source .046
of information
i
Independent
Variable N
newspaper as a 936
source of information
constant
age 823
income
constant
Beta
.159
.300
.154
.146
.049
_E_
.000
.000
.000
.000
.145
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39
considered a more important source of information by younger respondents
(Appendix Tables D-3 and D-4). All major sources of information except
friends were more strongly associated with awareness of specific advisory
information rather than general awareness, but use of friends as an
information source was associated more strongly with general (not specific)
advisory awareness.
Sources of information used differed by state of residence. Newspapers
were cited more frequently in West Virginia, Kentucky, and Indiana than in
other states (Appendix Table D-3). Television or radio was mentioned most
often by Illinois residents. The fishing regulations guide was used most
frequently by Ohio residents, and somewhat frequently by residents of Indiana,
Kentucky, and Illinois (the IL guide includes advisories for other IL waters
but not for the Ohio River). Posted warnings at fishing sites were used most
frequently by Kentucky residents, but rated very important by Pennsylvania
residents. Newspapers and posted warnings were considered more important
sources of information in urban areas than in rural areas (Appendix Table D-
4).
Respondents who used the fishing regulations guide felt most informed
about the safety of eating fish (3.6 on a scale of 5); those using friends
felt the least informed (3.0) (Appendix Table D-5).
Beliefs. Attitudes, and Behavioral Intentions
In this section of the report we describe how the beliefs and
perceptions of Ohio River anglers relate to health advisories and fish
consumption. We do not present detailed data based on socio-demographic
characteristics, except where important differences were found. .Detailed
socio-demographic comparisons are available in Appendix D.
-------
40
Beliefs. A slight majority of respondents (54%) believed that following
the advisory would limit the amount of Ohio River fish they consumed, but for *~
the majority of anglers (55%) not the enjoyment they get from Ohio River
fishing (Table 10). Those fishing the Cannelton to Uniontown section of the
river (see Fig. 2 for map location) were more likely to believe that following
the advisory would limit their enjoyment of fishing (Appendix Table D-6). ,»
i
Most respondents (59%) believed that government agencies do not really
know how much contaminants are in Ohio River fish. Comparatively, 44% of
respondents to a Great Lakes Basin health advisory study held a similar belief
about government agencies (Connelly and Knuth 1993). This belief was more
widely held among less educated respondents than those with a college degree .fa
•
or post graduate education, and among low to moderate income groups (Appendix :
Table D-6).
Most respondents (67%) disagreed with the statement that eating any fish
from the Ohio River is safe. Respondents were more likely to believe that jj,
eating some types of Ohio River fish is safe, but a majority (55%) either did
not hold this belief or were unsure (Table 10). The percentage of those
believing that eating some types of fish was safe was highest among older
respondents, males, and non-whites (Appendix Table D-7). Residents of
*~s
Illinois were more likely than residents of other states to believe that *"
eating some or any fish from the Ohio River was safe (Table 11). Illinois
issues no Ohio River health advisory, although it does issue advisories for
other waters in the state. Those fishing the Illinois and Indiana portions of
the river from Cannelton to the river mouth were most likely to believe that T
eating some or any fish from the Ohio River was safe. Respondents who ate
species listed in the advisories were also more likely than other respondents
-------
41
Table 10. Beliefs about following the advisory and eating Ohio River fish.
Beliefs About Following the Advisory
and Eating Ohio River Fish
Following Advisories Would Limit My
Enjoyment of Ohio River Fishing
Following Advisories Would Limit
Amount of Fish I Eat
Don't Think Government Agencies Know
How Much Contaminants Are In Fish
Eating Any Fish From the Ohio
River Is Safe
Don't
Agree Neutral Disagree Know
Percent
23.5 13.1
53.8 13.0
59.2 15.9
6.8
9.3
54.7 8.7
23.2 10.0
15.0 9.9
66.6 17.3
Eating Some Types of Fish From the
Ohio River is Safe
29.5 15.9
35.9 18.7
-------
42
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to believe that eating some or any fish from the Ohio River was safe.
Respondents who were aware of advisory specifics were more likely to believe
that eating some types of fish was safe. Respondents to the fall survey also
were more likely to believe that eating some types of fish was safe.
Most respondents believed that eating Ohio River fish posed some health
risk for them. They expressed this in their responses to a series of
questions asking them to evaluate the outcome of their decision to follow the
advisory or to consume fish (Table 12). A majority of respondents believed
that: (1) the health risks are greater than the health benefits (56%); (2)
eating contaminated fish over many years increases their health risks (71%);
and (3) Ohio River fish pose a health risk for them (58%). Respondents were
more evenly split over whether health risks from eating fish were minor
compared with other risks, although 51% either disagreed or were unsure. Many
respondents never had positive thoughts and often had negative thoughts about
the safety of eating Ohio River fish (Table 12).
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a scale that measures a respondent's overall evaluation of outcomes associated
with following the advisory and eating Ohio River fish. The concept of
outcome evaluation is a component of the Theory of Planned Behavior. Four of
i
the six variables, identified in Table 12, formed a single factor that
explained 51% of the variance and had a reliability coefficient (Cronbach's
alpha) of 0.67. These four variables were combined into one variable called
the "evaluation of outcomes" scale, for which l="health risks exist and are
greater than benefits" and 5="health risks do not exist". The perception that
health risks do not exist was held more strongly by older, less educated, and
\
r~
-------
45
Table 12. Evaluation of outcomes associated with following the advisory and
eating Ohio River fish.
"Don7!
Evaluation of Outcomes Associated With Agree Neutral Disagree Know
Following the Advisory/Eating Ohio River Fish Percent
The Health Benefits of Eating Ohio River
Fish Are Greater Than the Health Risks* 8.0 15.9 56.0 20.1
The Health Risks From .Eating Contaminated
Ohio River Fish is Minor Compared With
Other Risks* 28.1 20.8 36.5 14.6
I Don't Believe Ohio River Fish Pose
A Health Risk for Me* 20.7 11.5 58.1 9.7
Eating Contaminated Fish Over Many Years
Increases My Health Risks 71.1 7.4 8.7 12.8
Very Often Somewhat
or Often Often Seldom Never
Percent
Had Positive Feelings About the Safety
of Eating Ohio River Fish* 15.5 13.9 29.4 41.2
Had Negative Feelings About the Safety
of Eating Ohio River Fish 43.9 . 12.6 23.5 20.1
"Variable used in constructing "evaluation of outcomes" scale.
-------
i
46
non-white respondents and respondents who live in Illinois or who responded to
the fall survey (Appendix Table D-8).
Evaluation of outcomes and the belief that eating some types of fish is
safe were correlated highly with both advisory awareness and concern that
eating fish could be a health risk (Fig. 4). Path analysis showed that the
more aware people were of the advisory the more likely they were to believe
that health risks exist and that eating some types of fish is safe (Table 13).
The majority of respondents (73%) were not concerned about what others
would think of them if they followed the advisories (Appendix Table D-9).
Motivation to comply with important others was therefore not a strong factor
in predicting advisory-related behaviors (as measured in this study) (Table
13).
Respondents were asked about a variety of factors that might have made
it difficult for them to follow the advice in the health advisory. These
factors included control beliefs, such as being unable to tell from the
advisory which species or sizes of fish would be less affected by chemical
contaminants. Six control beliefs important to a plurality of respondents
were combined into one scale factor (Table 14). Each of these beliefs related
to having insufficient information in the advisory to choose safer
alternatives (e.g., safer locations, types or sizes of fish with less
contaminants, risk-reducing fish preparation methods). Based on principal
components factor analysis, the factor explained 58% of the variance and had a
reliability coefficient (Cronbach's alpha) of 0.85. The variable created from
the factor was compared with socio-demographic characteristics of respondents
but no significant differences were found (Appendix Table D-10). One item in
the factor, "couldn't tell from the advisory which types of fish have less
chemicals," differed between fall and spring implementations of the survey,
r"
-------
47
1.154*
' .146*
•a
I
Used Newspaper As A
Source of Advisory
Information
.£
*3
n
Outcomes Associated
With Consuming
Ohio River Fish
Motivation to
Comply With
Important
Others
Advisories
Provide Me
With Enough
Information
-.230*
-.388*
Concerned That
Eating Fish Could
Be A Health Bisk
Most People Important
To Me Think Eating
Fish is Safe
.356*
How Well Informed
Are You About the
Safety of Eating
Fish
L -.169*
CO
s
Consumed
lasted
Species
Above
- Limits -'
-.002
Use Bisk-reducing
Cleaning Techniques
Figure 4. Path diagram of social-psychological process determining response
to health advisories, with standardized regression coefficients
^ from an ordinary least squares regression. Asterisks indicate
; significant values (p = .05).
-------
48
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-------
50
Table 14. Control belief reasons for not following the recommendations in .
the health advisories.
V
Don't
Control Belief Reasons for Aoree Neutral Disagree Know
Not Following the Advisory Percent ;
Couldn't Tell From the Advisories Which
Locations Would Have Safer Fish 41.7 17.1 21.9 19.3
P!
Couldn't Tell From the Advisories Which
Types of Fish Have Less Chemicals 38.1 13.8 33.2 14.9
Don't Know How to Catch the Types of
Fish With Less Chemicals 19.4 "14.9 48.6 17.1
Couldn't Tell From the Advisories What
Sizes of Fish Have Less Chemicals 40.1 16.0 25.2 18.7
h
Couldn't Tell From the Advisories How to
Clean Fish to Reduce Chemicals 39.8 16.3 23.7 20.2
Couldn't Tell From the Advisories How to
Cook Fish to Reduce Chemicals 39.0 16.6 23.1 21.3
-------
with 29% more respondents in the spring having trouble telling which species
were less affected by chemicals than in the fall.
A second measure of control beliefs was a question asking if the health
advisory provided the respondent with enough information to make his/her own
decision about fish consumption. Approximately one-third of respondents felt
the advisory provided them with enough information; one-third felt the
advisory did not provide them with enough information, with the remaining
one-third being either unsure or neutral. A higher percentage of men, older
respondents, and nonwhites believed the advisory provided them with enough
information (Appendix Table D-10). Recall that these were the same
socio-demographic characteristics associated with a belief that eating some
types of Ohio River fish is safe, and similar to the characteristics of those
holding stronger beliefs that health risks do not exist. Respondents to the
fall survey were also more likely to agree that the advisory provided them
with enough information compared with spring respondents.
Attitudes. Most respondents were concerned that eating Ohio River fish
was a health risk (88%), and thought it was important to follow the health
advisories (71%). Respondents to the spring survey were on average more
concerned that eating fish was a health risk than respondents to the fall
survey. Similarly, those who caught listed species but did not consume them
were more concerned than those who ate or never caught listed species
(Appendix Table D-ll). As expected, residents of Illinois (which issues no
Ohio River health advisory) were less concerned about the health risks than
residents of other states.
Respondents were asked about their perceptions of the opinions of
important others (e.g., family and friends) regarding the respondent's fish
-------
52
consumption and whether they followed the health advisory. These questions
were intended ,to measure the subjective norm (see Fig. 4). The majority of
respondents believed that these important others thought that they should
follow the advisory (54%) and that eating fish from the Ohio River was not
safe (56%). As expected, residents of Illinois and respondents who consumed
species listed as unsafe were more likely to believe that important others
thought eating fish was safe (Appendix Table D-12). Respondents who were
aware of the advisory were more likely to think that important others thought
they should follow the advisory. Men were also more likely than women to
believe that important others thought they should follow the advisory.
The respondent's perceived control over his/her ability to follow the
advisory was measured by two questions: (1) how informed are you about the
safety of eating fish, and (2) how easy is it for you to follow the advisory
recommendations. On average respondents felt somewhat informed about the
safety of eating fish, and found it relatively easy to follow the advisory
recommendations (Appendix Table D-13). Older respondents and men were more
likely to feel informed regarding the safety of eating fish. Those that were
aware of advisory specifics felt more informed and found it easier to comply
with advisory recommendations than those only generally aware of the advisory.
Behavioral Intentions. A plurality of respondents (45%) believed that
they follow the advice in the health advisories. Reported fish consumption
patterns for 91% of this group indicated they followed the advisory. Older
respondents and men were more likely to believe they followed the advice in
the advisory (Appendix Table D-14). Those who were aware of advisory
specifics were twice as likely as those who were generally aware or not aware
to have said that they followed the advisory.
-------
53
A majority of respondents (63%) would eat more Ohio River fish if health
risks did not exist. Those who were aware of the health advisories were more
likely to say they would eat more fish if health risks did not exist (Appendix
Table D-14). Fish consumption suppression (actual consumption lower than
desired consumption due to contaminants) therefore appears to exist among Ohio
River anglers. We did not measure the magnitude of fish consumption
suppression in this study.
A plurality of respondents (46%) disagreed with the statement that if
the advisories said that only larger fish were unsafe they would eat smaller
fish. Many respondents who currently catch but do not eat listed fish (56%)
still would not eat the fish if the advisory said smaller fish were safe to
eat. Apparently, changing the advisory to distinguish relative safety based
on size of fish would not change the consumption pattern of many of those who
currently practice catch and release of listed species. However, Illinois
residents more than residents of any other state would be amenable to eating
smaller fish if they had an advisory that said larger fish were unsafe
(Appendix Table D-15).
Fishing Satisfactions. Respondents were asked to rate a list of items
in terms of the importance of each item to a satisfying fishing trip, not
necessarily on the Ohio River (Table 15). Over half of the respondents
reported the following two items as being essential for a really satisfying
fishing trip: being with friends or family (55%) and catching at least one
fish (51%). The items that were least important were to catch the most fish
of anyone in the group or to try out new fishing gear.
The items on the satisfaction scale were subjected to factor analysis to
investigate groupings or dimensions of fishing satisfaction. Five factors
-------
54
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55 x
were identified through factor analysis that explained 65.7% of the variance
and had a reliability estimate of 0.75 (Cronbach's alpha). The items which
loaded highest under each factor are shown in Table 15. For example, the
first factor, which we named "Catching Fishs" contains items related to the
«
importance of different types of catch (e.g. catch at least one fish, several
fish, large fish).
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almost identical factors were identified (Connelly et al. 1990). For New Yor
anglers, fishing in areas where the fish are safe to eat and catching fish to
eat were more important for a satisfying trip than for Ohio River anglers. For
Ohio River anglers, catching a few fish was very important, but consuming them
was not as important (Table 15).
Fish consumption was more important for a satisfying experience for
anglers from Kentucky and Illinois and for anglers with a high school or less
education (Appendix Table D-16).
As would be expected from our earlier analysis of beliefs, consumption
was more important for those eating listed species than for those who caught
but did not consume listed fish. This follows from our earlier finding that
those eating listed species were more likely to believe that following the
advisory would limit their enjoyment of fishing. For these respondents,
consumption appears to be an important part of the fishing experience, one
perhaps not easily given up.
Advisory-related Behaviors
Fishing Activity and Location. Most respondents appear to fish the Ohio
River on a consistent basis, with 93% of those fishing the river in the past
five years also fishing the river in 1991-92. (No differences were found
-------
56
between respondents to the spring and fall survey implementations in terms of
fishing activity even though the dates on the questions were different.
Respondents from both surveys were combined because the time frame on each was
a one-year period.) On average, anglers fished 31 days per year (range 1-350
days). Sixty-one percent of the days were spent in pools or river areas
between dams: the remainder at or near locks and dams. About 60% of the days
were attributed to fishing from shore; the remainder from boats of some type.
No difference was found between urban and rural residents regarding days
fished (Appendix Table D-17). Respondents from Illinois and Ohio fished the
Ohio River most frequently; Kentucky residents fished least frequently.
The majority of those who were not aware of the health advisory fished
the Ohio River 10 days or less in 1991-92. Fifty-nine percent of those that
fished 26 days or more said they were aware of the advisory specifics. The
advisory therefore appears to be somewhat successful in getting information
out to those who need it most (i.e., most frequent anglers).
Anglers were sampled from the entire length of the Ohio River so it is
not surprising that the percent of anglers as measured by the lock and dam
fished most frequently was distributed evenly along the length of the river,
with somewhat lower participation at each end of the river. This distribution
was an intentional part of the sampling process and thus we cannot make any
statements about the relative level of angling effort at different locations
along the river.
Fish Consumption. Most respondents (95%) who fished the Ohio River in
the past year reported catching at least one fish from the river, but less
than half of the respondents (43%) ate any Ohio River fish. On average,
fish-consuming respondents ate 19 Ohio River fish meals annually. How this
-------
57
consumption was partitioned between listed species and unlisted species is
discussed later in the report. The most popular fish species for both catch
and consumption was channel catfish (Table 16). Channel catfish, carp, white
bass, and paddlefish are listed species in at least one state's health
advisory. The latter three species, however, were either caught infrequently
or caught but not consumed. In fact, 92% of respondents who did not follow
their state's advisory were consuming channel catfish. Thus this species see -
to be the most popular and the one most often ignored based on the health
advisory warnings.
Overall, 11% of respondents did not follow the recommendations of their
respective state's advisory. An additional 42% caught species listed in the
advisory but did not consume them in excess of the advisory recommendations;
the remaining respondents did not catch or consume listed species. The latter
respondents were more likely middle-aged or elderly (Table 17). Respondents
from Kentucky, especially those fishing near the Uniontown, Newburgh, and
Cannelton locks and dams, were two to three times more likely to consume
species listed in the advisory (primarily channel catfish) than other anglers.
These areas are characterized by relatively good fishing access on one or both
sides of the river, which may contribute to higher catch and consumption of
channel catfish (J. Schulte, ORSANCO, per. comrn., May 1993; D. Bell, KYDFW,
per. comm., May 1993). The ratio of number of fish meals eaten to number of
fish caught was not substantially different for this river reach compared to
other sections of the river, indicating the source of the high consumption of
listed species is likely from sport-caught fish rather than through commercial
sources (e.g., fish markets). Respondents who fished this section of the
river most frequently were more likely to hold a suite of beliefs and
-------
58
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59
Table 17. Respondents' catch and consumption of listed species-overall, by
socio-demographic characteristics, state of residence, time of
survey, advisory awareness, days fished, location fished, and
major sources of information.
Fish Consumption Groups
Catch/Eat No
Listed Fish
Overal1
Age
15-29
30-39
40-49
50+
Education
Grades 1-11
Grad. High School
Some College
Grad. College
Some Post Grad.
Income
< $20,000
$21,000-$34,000
$35,000-$50,000
> $51,000
Sex
Male
Female
Race
White
Other
Residence Area
Urban
Rural
State of Residence
Pennsylvania
West Virginia
Kentucky
Illinois
Indiana
Ohio
46.7
37.7
41.7
54.6
54.9
50.4
45.8
44.3
45.3
58.2
44.5
44.0
46.1
45.0
47.8
40.7
46.0
63.4
46.1
47.2
28.
18.
21.
Catch/Eat
Listed Fish
Within Limits
Percent
Eat Listed Fish
Above Limits
100.0
23.5
86.1
42.2
50.0
45.0
36.3
36.1
35.8
42.2
44.5
52.0
34.3
42.3
44.3
43.9
47.3
41.7
44.9
42.8
26.8
44.0
40.4
69.8
74.9
42.3
0.0
71.7
12.2
11.1
12.3*
13.3
9.1
9.0
13.8
12.0
11.2
2.7
7.5
13.2
11.7
10.0
7.7
10.5
14.4
11.2
9.8
9.9
12.4
1
6.6
36.1
0.0
4.8
1.7
9*
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60
Table 17. (Cont.)
Time of Survey
Spring '92
Fall '92
Aware of Advisories
No
Generally Aware
Specifically Aware
Total Days Fished
1-10
11-25
26+
Catch/Eat No
Listed Fish
47.8
45.4
51.5
48.1
44.4
48.7
42.8
43.2
Fish Consumption
Catch/Eat
Listed Fish
Within Limits
Percent
44.9
38.4
43.3
40.5
44.0
44.6
42.8
43.5
Groups
Eat Listed Fish
Above Limits
7.3*
16.2
5.2
11.4
11.6
6.7*
14.4
13.3
Location Fished Most Frequently
Pittsburgh to Gallipolis
Greenup to McAlpine
Cannelton to Union town
Smith! and to Cairo
Don't Know
Sources of Information
Newspapers
Fishing Regulations
Posted Warnings
Television or Radio
Sources of Information
Newspapers
Fishing Regulations
Posted Warnings
Television or Radio
38.8
44.4
26.1
82.4
52.3
56.8
41.8
50.7
5.5 -
38.4
4.4*
13.8
23.2
12.1
9.3
Percent Checked8
40.4
52.4
41.5
40.8
40.7
29.3
26.8
37.8
18.9
18.3
31.7*
21.5
Mean Imoortanceb
3.5
3.1
2.7
3.1
3.7
3.0
3.0
3.4
3.1
3.1
2.6
2.9
*Statistically significant difference between groups at P < .05 using Chi-
square test.
"Question asked on the spring survey only. Respondents could check more than
one source of information.
Question asked on the fall survey only. Importance was measured on a scale
where 5 = extremely important to 1 = not at all important.
fc
-------
61
attitudes implying that they did not believe that the risk existed. For
example, they were less concerned about the personal risks associated with
listed species consumption (Appendix Table D-ll), more likely to think
important others thought eating fish was safe (Appendix Table D-12), and more
likely to believe that health risks do not exist (Appendix Table D-8). As
noted earlier, these respondents were also more likely than others to believe
that following the advisory would decrease their enjoyment of fishing.
Respondents to the spring survey were twice as likely to consume listet
species as those responding to the fall survey. Although both surveys
assessed annual fish consumption (but for different dates), it is possible
that the spring survey respondents exhibited better recall for spring-caught
species. White bass is the primary spring-caught listed species. We found no
significant differences in species-specific fish consumption between spring
and fall surveys, however, indicating such a possible recall bias likely did
not occur. We are not aware of any events that would contribute to a lower
annual consumption of listed species during Fall 1991 - Fall 1992 compared
with Spring 1991 - Spring 1992.
Respondents eating listed fish beyond the limits recommended in the
advisory were more likely to also eat unlisted fish species compared to
respondents keeping their consumption within advisory limits (Table 18). Fish
consumption as an activity appears to be important to anglers who exceed the
advisory recommendations, as discussed earlier (see Appendix Table D-16),
whether or not the species consumed is listed in the advisory.
Average annual consumption of listed fish species was about 11
meals/year compared with about 16 meals/year for unlisted fish species
(Appendix Table D-18). Among respondents consuming listed species, men
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62
Table 18. Percent of respondents in each fish consumption group eating
unlisted species and for those eating unlisted species the average
number of unlisted fish meals by fish consumption group.
Fish Consumption Groups
Catch/Eat No Listed Fish
Catch/Eat Listed Fish Within Limits
Eat Listed Fish Above Limits
% Eating
Unlisted Fish
42.8*
27.1
80.8
Average # Meals of
Unlisted Fish
17.4
13.3
17.8
*Statistically significant difference between those eating and not eating
unlisted fish at P < .05 using Chi-square test.
exhibited significantly higher annual consumption of listed species than women
(12.2 vs. 4.8 meals/year), and those fishing more than 25 days showed
significantly higher annual consumption of listed species than anglers fishing
less frequently (Appendix Table D-18). Although not statistically
significant, relatively high annual consumption of listed species occurred for
the oldest age group, the lowest income group, and those respondents fishing
two locations most frequently (Greenup to McAlpine, tannelton to Uniontown)
(Appendix Table D-18). Among respondents consuming unlisted species, those
fishing more than 25 days exhibited significantly higher annual unlisted
species consumption than anglers fishing less frequently (Appendix Table
D-18), indicating frequent fishers tend to be the most frequent fish
consumers. Annual consumption of unlisted fish species varied little among
each of the socio-demographic and, behavioral categories examined.
Consumption of listed species was related via path analysis to a series
of variables measuring outcome evaluations and behavioral beliefs (Fig. 4).
For example, one path with significant relationships suggests that (1) older
-------
63
anglers were more likely to use the newspaper as a source of health advisory
information, (2) those using newspapers were more likely aware of advisory
specifics, (3) those aware of advisory specifics were more likely to believe
that health risks exist, (4) those believing that health risks exist were mores
likely to be concerned that eating fish could be a health risk, and (5) those
who were concerned that eating fish could be a health risk were less likely t
consume listed species above the limit. No significant relationships were
found between consumption of listed species and control beliefs or normative
beliefs (Table 13).
Fish Preparation Methods. Certain cleaning and cooking techniques can
be used to reduce the health risks associated with contaminated fish
consumption. Thirty-five percent of Ohio River anglers said they used all
four risk-reducing cleaning techniques (remove back fat, remove belly fat,
remove skin, fillet fish) for all fish meals they prepared. Most anglers use
some of the risk-reducing cleaning techniques at least some of the time
(Appendix Table D-19). Those fishing the lower stretches of the river most
often were also more likely to use risk-reducing cleaning techniques more
frequently. Among anglers consuming listed species beyond advisory limits,
the majority used risk-reducing cleaning techniques most of the time. Those
catching but not consuming listed species beyond advisory limits were the
least likely to use risk-reducing cleaning techniques; since these anglers are
not consuming listed species, use of these techniques is not as important from
a health protection standpoint.
Use of risk-reducing cleaning techniques was related to both attitudes
about the safety of eating fish and motivation to comply with important others
(Fig. 4, Table 13). Concern that eating fish could be a health risk decreased
-------
64
as the use of risk-reducing cleaning techniques increased, indicating personal
behavior (i.e., adopting cleaning techniques) is related to magnitude of
health risk concerns. Overall, as noted above, those who eat listed species
beyond advisory limits are more likely to use the risk-reducing cleaning
techniques than those who do not eat fish beyond the advisory limits. The
magnitude of concern about the safety of eating Ohio River fish only makes a
difference for those who do not eat listed fish beyond the advisory limits
(Table 19). For this consumption group, those who were high in concern used
fewer risk-reducing cleaning techniques than those who were lower in concern.
This interaction should be investigated further in the future. One
possibility is that among those who stay within the guidelines, the high
concern group has done so purposely to reduce risk and sees no need to adopt
other risk-reducing behavior. On the other hand, the low concern members of
that group may be there more by chance than by purposely trying to avoid
eating too many proscribed fish. Those who felt that important others thought
eating fish was safe were more likely to use risk-reducing cleaning
techniques. Control beliefs (as measured in this study) were not related to
use of risk-reducing cleaning techniques.
Use of risk-reducing cooking techniques was not prevalent, even among
consumers of listed species beyond advisory limits. More popular cooking
methods included generally non-risk-reducing methods such as pan frying or
deep frying.
Consumption of sport-caught fish, including listed species, may occur
over a span of time, not just at the time the fish is caught. Over 80% of
anglers who ate listed species at least sometimes freeze or can their fish for
later use. This behavior may support the use of certain risk assessment
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65
Table 19. Mean use of risk-reducing cleaning techniques for respondents
exhibiting low and high concern about the safety of eating Ohio
River fish by whether or not they consumed fish above advisory
limits.
Level of concern
about the safety of Do not eat fish above Eat fish above
eating Ohio River fish advisory limits advisory limits
Low Concern
High Concern
3.9a
3.0
4.0
3.9
aUse of risk-reducing cleaning techniques was measured on a 5-point scale
•where 5 = all meals to 1 = no meals.
models that assume fish consumption is distributed throughout the calendar
year.
Changes in Behavior as a Result of the Health Advisory. Among
respondents who were aware of the health advisories, 42% said they had reduced
their fish consumption because of the advisory and 13% said they had stopped
consuming Ohio River fish altogether (Table 20). Taking fewer fishing trips,
changing fishing location or species fished for were mentioned by one-quarter
to one-third of respondents. Just over 20% said they changed cleaning
methods. Use of the fishing regulations guide was associated with respondents
taking fewer fishing trips and changing fishing locations (Appendix Table
D-20). Over half of the respondents from Kentucky who were aware of the
health advisories took fewer fishing trips because of the advisories.
Respondents who consumed listed species beyond advisory limits were more
likely than those who did not to say that because of the advisory they had
changed their cleaning methods and were eating less fish (Appendix Table
D-20). Those who were catching but not consuming listed species beyond
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*
66
Table 20. Changes made In response to the health advisories for those who
were aware of the advisories.
Changes Made
Take Fewer Fishing Trips
Changed Fishing Location
Changed Species of Fish*
Changed Cleaning Methods
Changed Sizes of Fish Eaten
Changed Cooking Methods
Eat More Fish
Take More Fishing Trips
Eat Less Fish
Stopped Eating Fish
Question asked only on the fall
Agree
37.3
26.3
26.0
22.6
17.2
13.3
12.9
9.0
Yes
41.8
13.3
survey.
Neutral
14.6
16.2
17.1
16.9
18.3
20.4
17.5
21.6
Disagree Don't Know
Percent
41.2 6.9
45.4 12.1
43.2 13.7
38.9 21.6
46.2 18.3
44.8 21.5
54.6 15.0
57.8 11.6
No
B
C
Percent
58.2
86.7
t
advisory limits were more likely to say the advisory had caused them to stop
consuming Ohio River fish. Almost three-quarters of those who had changed
cleaning methods were using risk-reducing cleaning methods for all fish meals
compared with one-third to one-half for other respondents who had not changed
cleaning methods (Appendix Table D-21). Conversely, those who said they had
changed cooking methods in response to the advisory were more likely to pan
fry or deep fry their meals, although the Ohio River advisories recommend
baking, roasting, grilling, or broiling fish and advise against frying.
Relationship of Behavior to Attitude Activation. In part, this study
was intended to extend previous experimental results about attitude
availability and accessibility to a more complex field situation. Previous
laboratory research and theory have posited that people have existing
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:67
attitudes that can be activated to stimulate certain actions or behaviors.
For example, in one relevant experiment the more environmental preservation-
related beliefs and experiences a subject recalled, the more that subject's
behaviors corresponded to earlier expressions of belief about environmental
issues (Kallgren and Wood 1986). Other studies have also found greater
consistency between attitudes and behavior when a relevant attitude about an
issue is more available or accessible in memory (Snyder and Kendzierski 1982).
Very early in the survey instrument used in this study, respondents who
reported fishing on the Ohio River within the past 5 years were asked to "list
all information you believe to be true about the safety of eating fish caught
in the Ohio River" and to "list specific actions you have taken related to the
safety of eating fish caught in the Ohio River." This technique is similar to
that used in several experimental studies (Wood 1982, Kallgren and Wood 1986,
Wood et al. 1985).
Respondents in the spring reported significantly more thoughts than in
the fall (mean thoughts spring = 3.0; fall = 2.6; t = 2.8; p <.01). Given
that the health advisories were issued in the spring just before the
questionnaire was mailed, this trend was expected. However, it does indicate
that the advisories may be cognitively somewhat less available by fall. For
the first "belief" question, about half the respondents overall listed no more
than one thought; for the second "action" question, almost half reported no
actions. For further analysis, responses to these two questions were summed
as the total number of thoughts.
The ability of these thoughts to mediate the relationship between
attitude ("concern that eating could be a health risk") and several behaviors
was examined. Using a technique suggested by Snyder and Kendzierski (1982),
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68
the correlation or point-biserial correlation between attitude and behavior
was computed separately for the high and low thought groups. This analysis
indicated that the greatest differences were between those who reported no
thoughts and those who reported at least some thoughts. For three of the four
behaviors (consumption of listed species, ceasing to eat Ohio River fish, and
use of risk-reducing cleaning techniques), the magnitude of the correlation
between concern and behavior for those who reported at least some thoughts was
greater than those who reported no thoughts (Table 21). However, the
interaction term in multiple regression indicated that this difference was
only significant for the relationship between concern and adoption of risk-
reducing cleaning techniques.
As discussed earlier, the more concerned the respondent, the less meals
were reported for which recommended cleaning techniques were used. However,
the more total thoughts the person had about beliefs and/or actions, the more
likely they were to use the risk-reducing cleaning techniques (r = .15; p
<.001). Earlier in this report, adoption of these cleaning techniques was
noted to be highest among respondents eating listed species beyond advisory
limits. A multiple regression indicated that concern, total thoughts and
eating listed species beyond advisory limits were each significant independent
predictors of using the recommended cleaning techniques; however, the only
significant interaction was that between concern and eating listed species
beyond advisory limits (see earlier section on fish preparation methods).
As in a previous experimental study (Wood 1982), respondents were asked
"how well informed are you about the safety of eating fish caught in the Ohio
River." Although those who wrote more "belief and "action" thoughts were
somewhat more likely to consider themselves well informed than those who had
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u
69
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70
few thoughts, the relationship was not great (r = .11, N = 1136; p <.001). In
addition, a greater number of thoughts was weakly but significantly related to
a greater frequency of negative feelings about the safety of eating fish
caught in the Ohio River (r = .08, N = 1101; p <.01).
Interest in Pollution Control. For almost two-thirds of respondents the
Ohio River health advisories have had the side benefit of increasing their
interest in water pollution control and cleanup efforts. This was
particularly true for Kentucky and Indiana residents, and those who felt
1 «
newspapers were an important source of information (Appendix Table D-22).
This sentiment was also significantly higher in the Cannelton to Uniontown
stretch of the river, the section that exhibited the highest levels of listed
species consumption beyond the advisory limits.
Communication Strategies
Although newspapers have been noted earlier in this report as a
frequently used and important source of information for respondents, when
asked about the best way to get information to them a plurality of respondents
(43%) said the television or radio would be best. Only 26% indicated
newspapers would be the best means of communication. However, preferences did
differ by age: 40% of respondents age 50 or over preferred newspapers,
whereas younger respondents (44-51%) preferred television or radio. The
fishing regulations guide and posted warnings were mentioned less frequently
by respondents (20% and 8%, respectively) as the best way to communicate
health advisory information. Note, however, that respondents who used the
fishing regulations guide felt most informed about the safety of eating fish,
as discussed earlier. .
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71
Respondents regarded most sources of information with a relatively high
degree of believability (Table 22). Those rated most believable in terms of
providing information about health risks were the state fishery management
agencies and the respondent's physician. No differences were found between
states in terms of believability.
Conclusions and Recommendations Regarding Health Advisory Impacts
Recommendations for Agencies
As noted in an earlier section of this report, the most important
objectives state/regional agencies hold for health advisories are reducing
health risks and helping people make their own informed decisions about
cleaning, cooking, and eating Ohio River fish. The most important evaluation
criteria identified by these agencies included advisory awareness, adoption of
risk-reducing fishing behaviors and fish preparation methods, and fish
consumption rates at or slightly below advisory recommendations. The results
from this study indicate the health advisory program has achieved success on
some, but not all, of these measures.
Health advisory awareness. Awareness of the advisory among licensed
anglers was generally high (83%) throughout the Ohio River valley. This level
of awareness is comparable to that in the Great Lakes Basin (Connelly and
Knuth 1993), although the Great Lakes health advisories (for some Lakes) have
existed for over 15 years compared to the 5-year history of Ohio River
advisories. Differences in advisory awareness among certain populations,
however, may indicate improvements in advisory communication are warranted.
Advisory awareness (as percent of respondents aware of advisory) was
lowest among anglers purchasing licenses in states using mainly news releases
to disseminate advisory information, and highest in those states in which the
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t
72
Table 22. Believability of sources of information regarding the potential
health risks from eating Ohio River fish.
Beli evabi1i tv
Sources of Information Mean8
State fishery management agency 3.6
Your own physician 3.5
State department of health 3.3
State environmental protection agency 3.3
U.S. Environmental Protection Agency 3.3
Sportsmen's associations 3.3
Friends or family 3.1
Television reports 3.1
Environmental interest groups 2.8
Newspaper reporters 2.8
Charter boat operators 2.6
"Measured on a scale which ranges from 5 - extremely believable to 1 = not at
all believable.
health advisory is printed in the fishing regulations guide. Those who used
newspapers as an information source, however, were more likely to claim
awareness of specific elements of the advisory than respondents using other
sources. Although survey respondents did not choose the regulations guide as
being the most effective means of communication, they did feel most informed
about the safety of eating fish after reading the regulations guide. States
should consider the merits of including health advisory information in the
fishing regulations guide, as well as in news releases to printed, audio, and
video media. Newspapers and posted warnings appeared to be particularly
important in urban areas.
As a group, women were less aware of the health advisory than men.
Because women are potentially at greater risk than men due to negative
reproductive and developmental impacts of consuming contaminated fish,
increased outreach to female anglers may be warranted. These efforts could
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73
include increased emphasis regarding the reasons for concern about female
consumption of some Ohio River fish, and different information distribution
methods to target women specifically (e.g., women's health care clinics).
Adoption of risk-reducino behaviors. A suite of risk-reducing behaviors
is available to potential fish consumers, including modifying the number of
fish meals eaten, choosing less-contaminated fishing locations, species, or
sizes of fish, and adopting contaminant-reducing fish cleaning and cooking
methods. Most of the Ohio River advisories do not include recommendations
based on the size of the fish, but rather present consumption advice for
entire species of fish. The majority of respondents indicated they would not
eat smaller fish if the advisory said only larger sizes had elevated
contaminant levels. Apparently, an advisory that distinguishes edibility
based on size of the fish would not change the fish consumption patterns of
many of those who currently practice catch-and-release of listed species.
Most respondents used some risk-reducing cleaning techniques at least
some of the time, but adoption of these methods was highest among respondents
eating listed species beyond advisory limits and among those listing a high
number of thoughts on the open-ended questions. The listed-species consumers
also appeared to be more committed to fish consumption as an important
lifestyle activity. Agencies should therefore consider emphasizing the
importance of using risk-reducing cleaning techniques especially if anglers do
not reduce fish consumption to recommended levels, because some anglers will
be unwilling to forego fish consumption altogether. Further, because
respondents listed more thoughts soon after advisories were issued than later
in the year, advisory reminders later in the fishing season or posted at
fishing areas may help anglers think more about the advisories. Since a
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i
74
greater number of thoughts was related to greater consistency between
attitudes and behaviors, stimulating such thoughts through reminders may make
risk-reducing behavior more likely.
Use of risk-reducing fish cooking techniques was not prevalent, even
among those who ate listed species. More attention to the benefits of using
such cooking techniques, as well as instructions about the techniques may be
warranted in health advisory information. Among anglers eating fish listed in
health advisories in other regions, prevalent adoption of risk-reducing
cleaning techniques and infrequent adoption of risk-reducing cooking
techniques is not unusual (Connelly et al. 1992, Connelly and Knuth 1993).
Fi sh consumpti on patterns. Although almost all respondents who fished
the Ohio River in the past year reported catching at least one fish, less than
half ate any Ohio River fish. Such relatively low consumption by anglers may
be of concern to agencies whose objectives include maintaining fish
consumption at or slightly below the levels recommended in the health
advisory. As discussed above, since the advisories pertain to only a portion
of Ohio River species, it is possible the fishery resource is being
underutilized in terms of human consumption. Of those eating Ohio River fish,
total annual consumption was 19 meals/year, and average annual consumption of
listed fish species was less than that for unlisted species (11 vs. 16
meals/year). Only about 11% of respondents did not follow the recommendations
of their respective state's advisory. In certain stretches of the River,
however, noncompliance with the advisory recommendations was considerably
higher (e.g., Cannelton to Uniontown), indicating targeted advisory
communication efforts may be warranted in these locales.
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75
Among anglers eating listed species above the advisory limits, fish
consumption was an important component of a satisfying experience. These
anglers were also more likely to believe that following the advisory would
limit their enjoyment of fishing. For this group, warnings to reduce fish
consumption for health reasons may not be sufficient to stimulate compliance
with the advisory. Rather, behavioral alternatives that still allow this
important personal activity (fish consumption) to occur may be needed, such as
risk-reducing preparation techniques or emphasis on eating species not listed
in the advisory.
Ability to make an informed decision. The Ohio River health advisories
pertain to only, a portion of the harvestable fish species in the river.
However, the presence of chemical contaminants in fish was an important reason
for not fishing the Ohio River for over half of the respondents who had not
fished the river in the past five years, and the only reason for 19% of
respondents who did not fish the river. In the Great Lakes Basin, only 3% of
respondents to a similar survey indicated contaminants were the sole reason
for not fishing the Great Lakes (Connelly and Knuth 1993). Among respondents
who fished the Ohio River, a majority did not believe eating even some Ohio
River fish was safe, although this belief was held more widely among those who
were familiar with the specific recommendations within the health advisory.
Few respondents ever had positive thoughts about eating Ohio River fish. If
state and regional agencies seek to emphasize the positive aspects of Ohio
River fish and fishing, catch-and-release fishing (already practiced by a
substantial portion of respondents) could be emphasized. Much more concerted
communication efforts would be needed to encourage consumption of the
harvestable fish species in the Ohio River that are not subject to advisories,
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76
and would involve changing pervasive beliefs about the desirability and safety
of Ohio River fish consumption. A majority of respondents (63%), however,
indicated they would eat more Ohio River fish if health risks did not exist.
It is possible that communicating the relatively low level of health risks
associated with eating some types of Ohio River fish would result in some of
these anglers harvesting and eating more of the available fishery resource.
Only about one-third of survey respondents believed the advisory
provided them with enough information to make their own, informed, decision
about fish consumption. A substantial portion of respondents indicated they
felt they had insufficient information in the advisory to choose safer
alternatives (e.g., safer fishing locations, types or sizes of fish with less
contaminants, risk-reducing fish preparation methods). Although such
information can be included in detail in news releases, it is limited in
extent in the advisory news releases currently used by agencies. Further,
agencies have little control over what the media chooses to include in
articles or broadcasts stemming from the news release. The fishing
, regulations guide provides a more certain vehicle for including detailed
advice about contaminant levels at different locations, species and sizes of
fish less-affected by contaminants, and risk-reducing fish preparation
methods. Diagrams depicting risk-reducing fish cleaning methods can be
included in the fishing regulations guide.
Recommendations for Research •
This study helped advance understanding of the social-psychological
process determining response to health advisories among licensed anglers,
building on Connelly et al. (1992). Several questions related to this process
emerge, however.
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77 •
First, Connelly and Knuth (1993) suggested that analyzing angler
behavior for the "extremes" of fish consumers (i.e., highest consumers of
listed species, former consumers who have ceased eating fish) would be
productive in advancing behavioral models. This study demonstrated that for
the highest fish consumers, fish consumption is an important and valued part
of the total fishing experience. In addition, high consumption of listed
species was associated with an array of attitudinal items, including attitudes
about risks from fish consumption. Future research could expand understanding
.of these relationships, testing the behavioral response of high-consuming
anglers if health advisory recommendations include an array of behaviors that
still allow some consumption to occur. For example, if informed about the
health risks associated with species a high-consuming angler normally catches,
will information about the relatively low risks associated with other
catchable species reduce consumption of the high-risk species but still allow
the angler to benefit from the totality of the fishing experience? Advisories
commonly include information about what species to avoid, but rarely include
detailed information about safer locations and species of fish.
The Ohio River presents a useful subpopulation of. anglers for such
research. The anglers from the Cannelton locks and dam down to the river
mouth were relatively different from other anglers in terms of higher fish
consumption, stronger beliefs that health risks do not exist, and greater
devotion to fish consumption as a part of the total fishing experience.
Future studies might target this river reach to understand further the
attitudinal, behavioral, and cultural factors influencing angler response to
health advisories.
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78
Second, this study demonstrated an association between the use of risk-
reducing cleaning techniques and lower levels of personal concern about the
health risks associated with consuming Ohio River fish. Future research could
test the hypothesis that anglers believe they do not have to follow the fish
consumption advice (i.e., number of fish meals per species) in health
advisories if they use risk-reducing cleaning techniques such as filleting the
fish or removing the fat. Testing this hypothesis is important for informed
risk management decisions. Some contaminants (e.g., mercury) are not reduced
through the use of such trimming techniques that reduce lipophilic compounds.
Anglers might think they are reducing their exposure when in fact they are
likely not. Further, some agencies (e.g., in Great Lakes states) are
considering adopting a health advisory protocol that would assume at least
some risk-reducing cleaning procedures are used when calculating contaminant
exposure estimations. Ohio River agencies would potentially be affected by
this protocol, since four of these agencies (IL, IN, OH, PA) also have
jurisdiction for the Great Lakes and would be unlikely to institute two
different protocols for fish advisory programs within the same state. Testing
this hypothesis would help confirm or refute the validity of this assumption
for risk management decisions.
Third, this study demonstrated that a significant portion of Ohio River
anglers do not eat Ohio River fish due at least in part to their belief that
the fish in the river are too contaminated to eat. The Ohio River health
advisories do little to communicate the benefits of fish consumption (e.g.,
health, economic), even though relatively few of the Ohio River fish species
are covered by the health advisories. Agencies could test the effects of
communicating the relatively low risks and associated benefits of eating some
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79
types of Ohio River fish to determine if such information results in higher
harvest and greater consumption of the available fishery resource.
Other topics for future research on communication and health advisory
awareness emerge from this study. Advisory awareness was highest in those
states that published the health advisory in the fishing regulations guide.
Pennsylvania began including its health advisory in the guide in December,
1992, after the data-gathering phase of this study was concluded. Changes in
health advisory awareness among Pennsylvania anglers could be monitored to
assess the effects of including this information in the regulations guide.
As in other studies, health advisory awareness and understanding
differed among socio-demographic groups. Of particular concern are women and
younger anglers, since these groups are likely at most risk from consuming
contaminated fish due to development and reproductive problems associated with
child-bearing, and due to the length of time younger anglers will experience
the effects of elevated body burdens of contaminants. Agencies could
implement and evaluate specific communication programs targeted to such
audiences. For example, women of childbearing age could be reached through
gynecological and obstetrical medical services, including both private and
public clinics. Younger anglers could be reached through schools (e.g.,
middle and high schools, community colleges) and through social programs ^
available to this age group. Beyond the advisory dissemination mechanism, the
information in the advisory should be written specifically to appeal to the
needs and interests of the target audiences. '_~ .
Finally, in this study we assumed that the advisories themselves made
relevant beliefs, attitudes, and behaviors more available and accessible.
This increased availability and accessibility was seen as making consistency
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80
between attitudes and behaviors more likely. However, making a behavioral
decision comes relatively late in mental processing. Rather than measuring
beliefs and behaviors just after anglers are informed of advisories (e.g., our
first mail survey in the spring after release of the new year's advisory),
future research could include a longitudinal design. Such a design would
measure beliefs and behaviors in anglers prior to either (a) learning about an
advisory or (b) learning about an updated advisory (as in the Ohio River
study), and again after exposure to the advisories. Experimental results from
other studies suggest that mentally stored beliefs and actions may influence
an early stage of mental processing (e.g., Wood 1982), such as interpretation
of the advisories when they are first encountered. Such a longitudinal
research design would likely be most effective in situations for which new or
substantially different health advisories are being released.
A SUMMARY OF RISK COMMUNICATION CONCEPTS FOR COMMUNICATING HEALTH ADVISORIES
The third objective of this study was to summarize risk communication
issues agencies should consider when designing health advisory communication
programs for public audiences. This section reflects the results of health
advisory-related research and evaluation conducted by the HDRU over the past
six years. A more comprehensive guidance document for health advisory risk
"communication is being prepared at the time of this writing. That document,
available in July, 1994, can be requested by contacting the HDRU.
„ r ,
V
A Framework for Health Advisory Communication Programs
The Model
Communicating health advisories is a form of risk communication, a
process of sharing information about perceived and potential dangers
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81
associated with a risk. In this case, the risk is that of potentially
impaired health due to consumption of fish tissue with elevated contaminant
levels. The concept of "sharing" is emphasized in risk communication
programs, particularly in health advisory communication programs. Health
advisories are prepared and issued by a variety of government agencies, mostly
health, environmental quality, and fishery management agencies at the state
level, but involving other federal, tribal, regional, and local government
offices (Reinert et al., 1991). Health advisory recommendations and advice
are disseminated by these same agencies, by other government-affiliated groups
such as Cooperative and Sea Grant Extension services, by non-government
interest and advocacy groups, and through various news media. Health advisory
•
recommendations are targeted toward a variety of people—sport anglers,
subsistence fishers, actual and potential fish consumers, high-risk groups,
and many different sociodemographic groups of people. Sharing information,
perceptions, and understanding among these various participants is critical to
successful health advisory communication programs.
Springer (1990) proposed a model that could be used to guide development
of health advisory communication programs. Essentially, the model contains
five elements: (1) problem analysis; (2) audience needs assessment; (3)
communication strategy design; (4) communication strategy implementation; and
(5) evaluation. Problem analysis includes consideration of the social,
scientific, and political context of the fish contaminant issue, particularly
specific articulation of the objectives to be accomplished through a health
advisory communication program. Audience needs assessment includes
identification of potential target audiences who should participate in the
health advisory communication program, and addresses what types of information
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82
and communication styles are appropriate for each audience. Design and
implementation of the communication strategy involves constructing health
advisory recommendations appropriate to the needs of the target audiences, and
sharing these recommendations using dissemination mechanisms that will reach
each audience of concern. Evaluation includes measurement of changes in
knowledge, attitudes, and behavior among the audiences, as well as assessment
of how well original health advisory objectives were met.
Problem Analysis: Objectives
Health advisories are issued by state agencies (and other organizations)
for a variety of purposes. The fundamental problem driving this process is
the presence of elevated levels of chemical contaminants in the tissue of some
fish. How each agency or organization decides to respond to and issue
recommendations about contaminated fish reflects the mandates, goals, and
objectives of each agency or organization. Health advisory communication
programs should be designed and evaluated with these specific objectives in
mind.
A variety of objectives have been identified for health advisory
communication programs (see earlier section of this report; also Knuth and
Connelly 1991), including reducing human health risks, encouraging informed
decisions among potential and actual fish consumers, fostering adoption of a
variety of risk-reducing behaviors, encouraging support for clean-up of toxics
in the environment, encouraging enjoyment of sport-fisheries, and informing
people about the health and economic benefits of fish consumption. Some of
these objectives may appear to be contradictory (or at least difficult to
balance), such as limiting consumption of contaminated fish while encouraging
people to derive the /health and economic benefits associated with eating
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83
sport-caught fish. Agencies, other organizations, and target audiences should
have a clear understanding of which objectives are to be achieved through a
health advisory communication program. Without such understanding, it is
virtually impossible to identify the "most appropriate" health advisory
recommendations and communication programs. Communicators and target
audiences alike should be aware that not all participants in health advisory
programs will share the same set of objectives they are hoping to achieve,
leading at times to confusion or conflict.
Audience Needs Assessment
Identifying target audiences. Identification of potential target
audiences for health advisory communication programs should flow from the
objectives articulated during problem analysis. Audiences may include, for
example, the general public if the objective is to stimulate concern for
clean-up of contaminated waters, or women of childbearing age if the objective
is to reduce health risks among populations most at-risk from the effects of
chemical contaminants. To achieve a variety of objectives or reach a variety
of audiences, usually a variety of communication strategies is needed, as
described in the next section. The information needs of these audiences and
the communication strategies used to convey that information may differ
substantially.
For example, potential audiences may differ in the ease in which health
advisory communicators can identify (and therefore contact) individual
members. For some groups, such as licensed recreational anglers, individual
members are identified easily and the means to reach those individuals are
relatively straightforward. Licensed anglers, for example, can be contacted
at the point of license purchase or by telephone or mailing address if such
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84
information is gathered at the time the license is sold. In contrast,
individuals in other groups, such as unlicensed subsistence fishers, may be
very difficult to identify. Personal observation of fishing access sites or
local fishing areas may be needed to assure identification of these potential
fi sh consumers.
Assessing the information needs of only licensed anglers will be
inadequate for some health advisory objectives such as those related to the
general public, but will also be inadequate for objectives related to reaching
the entire population of actual or potential anglers and fish consumers. In
some states, for example, licenses are not required for anglers above or below
certain ages, anglers with certain types of physical impairments, or anglers
•
fishing in areas under specific private ownership. In some cases, these
anglers (e.g., youth) may be among the high-risk audiences identified in
health advisory program objectives. In addition, fish caught by licensed
anglers may be shared with non-angling family members or friends. Care must
be given during audience needs assessment to first identify the universe of
target audiences necessary to reach, considering both the objectives of the
health advisory communication program and the range of behavioral and
sociodemographic groups of people implied by those objectives.
Audience information and communication needs. Whether information about
a particular target audience is collected via a sampling of individuals within
that group or observations of the group as a whole, health advisory
communicators should not only identify who the target audiences are relative
to the objectives to be achieved, but also what the information needs and
communication needs of those audiences are. This process includes
understanding what the target audiences initially know and believe about
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85
health advisories and fish consumption, how they behave relative to fish
consumption, and what information they desire. For example, awareness of
existing health advisories typically increases in a given population over
time, but tends to be lower among certain audiences (e.g., women, youth, those
with relatively low education or low income, non-whites). Knowledge of
specific health advisory concepts is variable among audiences, but has
typically been highest regarding negative health effects associated with
eating contaminated fish, and lowest regarding special recommendations for
women of childbearing age and children. Depending on the health advisory
objectives, reaching such low-awareness groups or targeting areas of generally
low knowledge may take high priority for a communication program's new
initiative.
Perceptions of what is important to know about health advisories and
fish consumption may differ considerably between target audiences and "expert"
health advisory communicators (such as health and fishery agency
professionals) (Springer 1990). If communicators design communication
programs based solely on their own beliefs about what audiences should know,
it is likely audiences will not find the suite of information they believe
they need to make an informed decision to follow or ignore the health advisory
recommendations.
Types of information identified by potential target audiences as
important for health advisories include the following, based on a series of
studies of licensed and unlicensed anglers conducted by the HDRU: (1) specific
comparisons of relatively safer/more dangerous fish species, sizes, and
fishing locations; (2) description of negative health effects from eating
fish; (3) health benefits of eating fish; (4) specific comparisons of health
-------
86
risks from fish consumption with other, particularly dietary, risks; (5)
description of risk-reducing fish cleaning and cooking methods; (6)
description of chemicals of concern and their effects. In designing a health
advisory communication program, communicators should assess which of these (or
other) information needs are most important to their own audiences of concern.
Audience behavior. Finally, assessment of behavior among audiences of
concern is necessary. Behaviors of interest include fishing and fish-eating
activities, as well as use of potential information sources (e.g., fishing
regulations guides, newspapers, personal communications). Understanding which
information sources will be used by audiences to receive health advisory
information is critical in designing a communication strategy. Understanding
what behaviors fish consumers engage in is necessary in deciding what current
behaviors to reinforce or to change via health advisory messages.
The series of. studies by the HDRU have demonstrated a range of
behavioral responses to health advisories, but most commonly these changes
include eating less (or no) sport-caught fish, changing fish preparation
methods, and changing species sought and locations fished. Adoption of
risk-reducing cooking methods is much less prevalent among anglers. In each
population studied, the likelihood of changing behavior in response to
advisories is relatively lower among females, low-income anglers, young
anglers, and less-educated anglers. Adherence to advisory recommendations has
ranged from 80% to 47% of licensed anglers abiding by existing health advisory
advice. For those who eat in excess of health advisory recommendations, fish
consumption has been associated with relatively lower knowledge about the
negative health effects of eating contaminated fish, certain beliefs about the
severity of potential health risks associated with contaminated fish
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87
consumption, and the use of risk-reducing fish cleaning methods.
Understanding the linkages between fish consumption behaviors, knowledge, and
beliefs is important for communicators in designing a health advisory message
and determining how best to send that message so it is received by specific
target audiences.
Communication Strategy; Design and Implementation
Developing the advisory message. As noted above, a variety of
information may be included in a health advisory beyond the specific
recommended fish consumption limits. Depending on the target audience, health
advisories may include information such as: (1) a description of a suite of
risk-reducing behaviors beyond limiting or eliminating fish consumption (e.g.,
fish cleaning and cooking techniques); (2) explanations of how eating fish
compares to other dietary risks; (3) description of the negative and positive
health effects associated with fish consumption, with special emphasis on what
groups of people are most endangered by or derive the most benefit from
sport-caught fish consumption; and (4) explanation of the assumptions and
uncertainty entering into the risk assessment-risk management process forming
the basis for issuing health advisories. Decisions about what information to
include in any advisory should reflect the self-identified needs of the target
audiences as well as the objectives of the health advisory program.
Styles for presenting advisory information. Only one major study has
assessed angler preferences in depth for different styles of presenting
advisory information (Connelly and Knuth 1993). A clear preference was shown
among Great Lakes licensed anglers for advisory information presented in a
cajoling rather than a commanding tone, implying anglers wish to feel they are
making the choice about fish consumption rather than being required to adopt
-------
the health advisory advice. Other results from that study indicated a
combination of text and diagrams (rather than one or the other) is likely most
effective for communicating some advisory information by printed means (e.g.,
fish cleaning methods), and that anglers desire at least some quantitative
information about the relative risks of fish consumption rather than only
qualitative descriptions. Again, presentation styles should cater to the
needs and abilities of the target audiences.
Advisory dissemination mechanisms. A variety of mechanisms exist by
which potential fish consumers receive information about health advisories and
contaminated fish consumption. These include interpersonal sources (e.g.,
friends, government agency professionals), mass media (e.g., newspapers,
television), and specialized media (e.g., printed fishing regulations guide,
health advisory brochure). This and other studies by the HDRU have
demonstrated an association between the use of fishing regulations guides
containing health advisory recommendations and relatively high levels of
advisory awareness, knowledge, and compliance with recommendations. The
highest levels of health advisory knowledge have been associated with personal
communication with "experts" (i.e., professionals from state health and
fishery agencies). The majority of these studies, however, have been
conducted with licensed anglers.
Fishing regulations guides appear to be an effective means of
disseminating health advisory recommendations to licensed anglers (although
some licensed anglers do not use them), but other mechanisms are required to
reach other audiences. Mechanisms accessible to other audiences of concern
include newspapers, television, posted warnings at access sites or in urban
areas, and specialized brochures distributed in areas used by the audiences of
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89
concern (e.g., maternal health brochures in clinics and physicians' offices).
Using mechanisms other than fishing regulations guides and brief press
releases may require that agencies become more actively involved in working
with mass media communicators to ensure the full thrust of a health advisory
message is actually included in the newspaper or television feature. Personal
contacts may be required to reach some audiences not exposed to guides or mass
media, and as noted above, have been the most effective mechanism for
achieving high levels of advisory knowledge and adoption of risk-reducing fish
cleaning techniques.
Timing of advisory dissemination. Timing the release of health
advisory recommendations will depend in part on what dissemination mechanism
is chosen. For example, health advisory recommendations to be printed in the
fishing regulations guide must be available at the time the guide is printed.
The results of this study, however, showed that advisory reminders throughout
the fishing season may cause anglers to think more about health advisories,
and lead to compliance with advisory recommendations. Anglers who consult
their fishing regulations guide regularly receive these ongoing reminders.
For other audiences, ongoing features about fish consumption and contaminants
during the fishing season may stimulate more awareness and therefore more
compliance with advisory recommendations.
Evaluating the Communication Program
As noted earlier, the means used and information collected when.
evaluating a health advisory communication program should reflect, at least in
part, the health advisory program objectives for which the communication
program was designed. Two basic types of evaluation are possible, formative
and summative evaluations.
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90
Formative evaluations of health advisory communication programs focus on
the process of communication, assessing whether the communication program is
being carried out as intended. Questions addressed include, for example: (1)
Do the dissemination mechanisms being used match the needs identified for each
audience?; (2) Are the media contacts planned actually being used and
»
maintained?; (3) Is the information intended for the health advisory actually
included in the various advisory dissemination mechanisms? Formative
evaluation can be an ongoing process of monitoring implementation of the
health advisory communication program, and can help identify necessary changes
in program implementation.
Summative evaluations of health advisory communication programs focus on
the outcomes produced through the communication process. Health advisory
program objectives serve as a basis for this evaluation. Evaluators assess
whether or not objectives were achieved, or whether outcomes were accomplished
that were prerequisite to objectives being achieved. As noted earlier,
summative evaluation may include a range of measurements of awareness,
knowledge, beliefs, and behaviors among fish consumers, depending on the
program objectives. Measurements should be collected for each of the
audiences of concern to assess the success of the communication program in
meeting the program objectives for each of the audiences. What constitutes
"success" in summative evaluations may change over time. For example, a 50%
level of advisory awareness may be quite acceptable following the first year
an advisory is issued, but undesirable after an advisory has been in effect
for several years. Conducting summative evaluations over time builds an
evaluation information base that helps the communicator identify successes and
areas needing improvement based on the measurement trends.
n
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91
During the formative or summative evaluation processes, new
communication issues or problems or previously unidentified audiences or
audience needs may surface. When this happens, the health advisory
communication program cycles back to the initial steps of the process, problem
analysis and audience needs assessment. Revised communication strategies may
result.
Summary
This and other studies of health advisory communication programs and
response by fish consumers shed light on the relationships between
information, knowledge, beliefs, and behavior. An important finding from each
of these studies is that fish consumers do not belong to a moriotypical
audience. Variations in beliefs, behaviors, and abilities demand attention by
communicators to specific target audiences. Communicators can gather original
information specific to their local audience needs, or draw from the
information on audience trends documented in studies of anglers, fish
consumers, and health advisories conducted by the HDRU and others. The result
should be improved health advisory communication programs, human health, and
sport-fisheries.
LITERATURE CITED
Ajzen, I. 1989. Attitude structure and behavior. Pages 241-274 IN A.R.
Pratkanis, S.J. Breckler, and A.G. Greenwald, eds. Attitude structure
and function. Lawrence Erlbaum Associates, Hillsdale, N.J.
Ajzen, I. and N. Fishbein. 1980. Understanding attitudes and predicting
social behavior. Prentice-Hall, Englewood Cliffs, N.J.
Blalock, H.M., Jr. 1985. Causal models in the social sciences. Aldine Publ.
Co., New York.
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92
Brown, T.L. 1991. Improvement of rural and agricultural sample survey
methods. Proposed Western Regional Project W-183. 30pp.
Brown, T.L., and B.T. Wilkins. 1978. Clues to reasons for nonresponse, and
its effect on variable estimates. J. of Leisure Research. 10(3):226-
231.
Connelly, N.A., T.L. Brown, and B.A. Knuth. 1990. New York statewide angler
survey 1988. New York State Department of Environmental Conservation,
Albany. 158pp.
Connelly, N.A. and B.A. Knuth. 1993. Great Lakes fish consumption health
advisories: angler response to advisories and evaluation of
communication techniques. Human Dimensions Research Unit Series No. 93-
3. Department of Natural Resources, Cornell University, Ithaca, New
York. 109pp.
Connelly, N.A., B.A. Knuth, and C.A. Bisogni. 1992. Effects of the health
advisory and advisory changes on fishing habits and fish consumption in
New York sport fisheries. Human Dimensions Research Unit Series No. 92-
9. Department of Natural Resources, Cornell University, Ithaca, New
York. 120pp.
Diana, S.C., C.A. Bisogni, and K. L. Gall. 1993. Understanding anglers'
practices related to health advisories for sport-caught fish. Journal
of Nutrition Education, (in press)
Fazio, R.H. 1986. How do attitudes guide behavior? IN R.M. Sorrentino and
E.T. Higgins, eds. Handbook of Motivation and Cognition Foundations of
Social Behavior. Guilford Press, New York.
Fiore, B.J., H.A. Anderson, L.P. Hanrahan, L.J. Olson, and W.C. Sonzogni.
1989. Sport fish consumption and body burden levels of chlorinated
hydrocarbons: a study of Wisconsin anglers. Archives of Environmental
Health. 44:82-88.
Kallgren, C.A., and W. Wood. 1986. Access to attitude relevant information
in memory as a determinant of attitude-behavior consistency. Journal of
Experimental Social Psychology. 22:328-338.
Knuth, B.A. 1989. Implementing chemical contaminant policies in
sport-fisheries: agency partnerships and constituency influence.
Journal of Management Science and Policy Analysis. 6(4):69-81.
Knuth, B.A. 1990. Risk communication: a new dimension in sport-fisheries
management. North American Journal of Fisheries Management.
10:374-381.
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u
93
Knuth, B.A., and N.A. Connelly. 1991. Objectives and evaluation criteria for
Great Lakes health advisories: perspectives from fishery, health, and
environmental quality agencies. Human Dimensions Research Unit Series
No. 91-11. Department of Natural Resources, Cornell University, Ithaca,
New York. 21pp.
ORSANCO. 1991. News release on Ohio River fish tissue analysis. Ohio River
Valley Water Sanitation Commission, Cincinnati, OH.
Reinert, R., B.A. Knuth, M. Kamrin, and Q.J. Stober. 1991. Risk assessment,
risk management, and fish consumption advisories in the United States
Fisheries. 16(6):5-12.
Shapiro, M.A. 1991. The effect of headlines on attitude activation and
agenda setting. Paper under review by Communications Research for
possible publication. Department of Communications, Cornell University,
Ithaca, New York.
Snyder, M., and D. Kendzierski. 1982. Acting on one's attitudes: procedures
for linking attitude and behavior. Journal of Experimental Social
Psychology. 18:165-183.
•
Springer, C.M. 1990. Risk perceptions and communication needs in Lake
Ontario's chemically contaminated sport fishery. Master's Thesis.
Department of Natural Resources, Cornell University, Ithaca, New York.
SPSS Inc. 1986. Statistical package for the social sciences users guide.
2nd edition. Chicago, IL. 988pp.
Wood, W. 1982. Retrieval of attitude-relevant information from memory:
effects on susceptibility to persuasion and on intrinsic motivation.
Journal of Personality and Social Psychology. 42(5):798-810.
Wood, W., C.A. Kallgren, and R.M. Preisler. 1985. Access to attitude-
relevant information in memory as a determinant of persuasion: the role
of message attributes. Journal of Experimental Social Psychology.
21:73-85.
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94
APPENDIX A.-
Li sting of MSA and non-MSA counties
-------
-------
Table A-l.
95
Listing of MSA and non-MSA counties by state, used in spring
sample selection procedure.
\
State
Pennsylvania
Ohio
Indiana
Illinois
Kentucky
MSA
Counties
Allegheny
Beaver
Jefferson
Belmont
Washington
Lawrence
Clermont
Hamilton
Dearborn
Clark
Floyd
Harri son
Warrick
Vanderburgh
Posey
Henderson
Daviess
Bullitt
Jefferson
Oldham
Boone
Kenton
Campbel1
Greenup
Boyd
non-MSA
Counties
Columbiana
Monroe
Athens
Meigs
Gallia
Scioto
Adams
Brown
Ohio
Switzerland
Jefferson
Crawford
Perry
Spencer
Gall atin
Hardin
Pope
Massac.
Pulaski
Ballard
McCracken
Livingston
Crittenden
Union
Hancock
Breckinridge
Meade
Trimble
Carrol1
Gallatin
Pendleton
Bracken
Mason
Lewis
-------
West Virginia
96
MSA
Counties
Wayne
Cabell
Wood
Marshall
Ohio
Hancock
non-MSA
Counties
Mason
Jackson
Pleasants
Tyler
Wetzel
Brooke
\
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97
APPENDIX B:
Spring and Fall Mail Questionnaires
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SPRING SURVEY INSTRUMENT
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OHIO RIVER VALLEY
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114
APPENDIX C:
Tests for Nonresponse Bias and
Calculations for Nonresponse Adjustments
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119
Calculations to Account for Nonresoonse Bias
From the original sample of 5,000, 404 were undeliverable, 2110
responded, and the rest (2,486) were nonrespondents. From the nonrespondents,
251 were interviewed by telephone (151 from the spring sample, 100 from the
fall). We assume that those interviewed by telephone are representative of
all nonrespondents. Undeliverable surveys will be dropped from the analysis
here because we know nothing specific about their fishing behavior and we
assume that they are similar to the general angling public.
The following calculations were made to estimate the percentage of the
survey population (respondents and nonrespondents) responding in each
category. For those fishing the Ohio River in the past five years:
Respondents
Nonresoondents
Total
Percent Aware
•of Health Advisory
86.9
80.1
83.3
n Aware
of Health Advisory
1,045
1.113
2,158
For those aware of health advisories and surveyed in the spring sample:
Respondents
Nonrespondents
Total
Percent Using Newspapers
as a Source of Info
70.2
55,9
63.0
n Using Newspapers
as a Source of Info
306
247
553
Info
Respondents
Nonrespondents
Total
Respondents
Nonrespondents
Total
Respondents
Nonrespondents
Total
436
442
878
Percent Using Magazines
as a Source of Info
Percent Using Fishing Regs.
Guide as a Source of Info
21.6
14?5
Percent Using Friends
as a Source of Info =
51.8
37.6
n Using Magazines
_ = as a Source of
73
_33
106
n Using Fishing Regs.
Guide as a Source of Info
94
33
127
n Using Friends
as a Source of Info
226
104
330
-------
-------
120
APPENDIX D:
Detailed Tables
v
-------
-------
121
Table D-l. Percent of respondents who had fished the Ohio River in the past
five years-overall, by socio-demographic characteristics, and by
state of residence.
Fished Ohio
River
Within Past Five Years
Overal 1
Age
15-29
30-39
40-49
50+
Education
Grades 1-11
Grad. High School
Some College
Grad. College
Some Post Grad.
Income
< $20,000
$21,000-$34,000
$35,000-$50,000
> $51,000
Sex
Male
Female
Race
White
Other
Residence Area
Urban
Rural
State of Residence
Pennsylvania
West Virginia
Kentucky
Illinois
Indiana
Ohio
No
Percent
42.9
31.7
40.5
45.4
49.2
43.8
41.0
40.5
50.0
45.3
39.9
42.0
43.3
46.4
39.5
54.1
42.6
34.3
43.3
40.9
63.9
34.5
47.7
32.3
54.4
29.2
Yes
57.1
68.3*
59.5
54.6
50.8
56.2
59.0
59.5
50.0
54.7
60.1
58.0
56.7
53.6
60.5*
45.9
57.4
65.7
56.7
59.1
36.1*
65.5
52.3
67.7
45.6
70.8
^Statistically significant difference between groups at P < .05 using Chi-
square test.
-------
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Table D-5. For respondents to the spring survey, how informed they felt about
the safety of eating fish by the sources of information they used.
Source of Information Used
Newspaper Article or Editorial
Television or Radio
Friends
Fishing Regulations Guide
Magazine Article
Warnings Posted at Fishing Sites
How Informed Are You About
The Safety of Eatino Fish?
Mean'
3.3
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Table D-8. Evaluation of outcomes scale variable-overall and by socio-
demographic characteristics, state of residence, timing of the
survey, advisory awareness, location fished most frequently, and
fish consumption groups.
Overall
Age
15-29
30-39
40-49
' 50+
Education
Grades 1-11
Grad. High School
Some College
Grad. College
Some Post Grad.
Income
< $20,000
$21,000-$34,000
$35,000-550,000
> $51,000
Sex
Hale
Female
Race
White
Other
Area of Residence
Urban
Rural
State of Residence
Pennsylvania
West Virginia
Kentucky
Illinois
Indiana
Ohio
Time of Survey
Spring '92
Fall '92
Evaluation of Outcomes Scale
Mean*
2.3
d
2.2d
2.3
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2.7"
2'2b
2.2b
2-2b
2.2b
2.4
2.3
2.3
2.2
2.3
2.2
2.3b
2.8a
2.3
2.3
2.2b
ZAl
2.3b
2.9"
2-3b
2.1b
2.2b
2.3a
-------
135
Table D-8. (Cont.)
Aware of Health Advisories
No
Generally Aware
Specifically Aware
Location Fished Most Frequently
Pittsburgh to Gallipolis
Greenup to McAlpine
Cannelton to Uniontown
Smith!and to Cairo
Don't Know
Fish Consumption Groups
Catch/Eat No
Listed Fish
Catch/Eat Listed
Fish Within
Limits
Eat Listed Fish
Above Limits
Evaluation of Outcomes Scale
Mean*
1.9"
2.3a
2.2a
-
2.2b
2.7a
2.8a
2.3b
2.3a'd
2.1b'd
2.8°
*Measured on a scale where 1 = health risks exist and are greater than
benefits to 5 = health risks do not exist.
a>bMean of group a is statistically significantly higher than group b at
P - .05 using t-test or Scheffe's test where appropriate.
c> Mean of group c is statistically significantly higher than group d at
P = .05 using t-test or Scheffe's test where appropriate.
-------
136
Table D-9. Was respondent concerned about what others might think of them if
they followed the advisory-overall and by socio-demographic
characteristics, state of residence, timing of the survey,
advisory awareness, and fish consumption groups.
Concerned About
Overal 1
Age
15-29
30-39
40-49
50+
Education
Grades 1-11
Grad. High School
Some College
Grad. College
Some Post Grad.
Income
< $20,000
$21,000-$34,000
$35,000-$50,000
> $51,000
Sex
Male
Femal e
Race
White
Other
Residence Area
Urban
Rural
State of Residence
Pennsylvania
West Virginia
Kentucky
Illinois
Indiana
Ohio
Time of Survey
Spring '92
Fall '92
Agree
5.9
6.0
7.4
4.7
5.0
9.3
7.0
4.9
3.1
3.1
9.4
5.2
4.6
3.4
6.4
3.1
5.6
13.3
6.3
5.5
10.3
4.7
4.5
3.2
5.9
8.6
5.9
5.8
Of Me If
Neutral
10.6
10.6
9.2
11.8
10.1
8.2
11.4
11.1
7.7
6.3
11.5
7.6
12.2
9.4
10.5
9.2
10.3
10.0
9.6
11.1
10.3
9.4
8.5
18.3
6.5
12.9
9.9
11.0
What Others
Might Think
I Follow Advisories
Disagree
Percent
73.5
72.3
75.6
72.2
73.9
61.9
70.4
76.8
84.6
89.1
-
65.6
77.2
77.6
79.5
73.5
74.7
74.4
60.0
74.0
73.4
66.6
71.3
80.9
67.7
78.4
67.8
74.5
72.7
Don't Know
10.1
11.1
7.8
11.3
11.0
20.6*
11.2
7.2
4.6
1.6
13.5*
10.0
5.6
7.7
9.6
13.0
9.7
16.7
10.1
10.1
12.8
14.6
6.1
10.8
9.2
10.7
9.7
10.5
-------
137
Table D-9. (Cont.)
Concerned About
Of Me If I
Aware of Health Advisories
Generally Aware
Specifically Aware
Agree
5.2 ,
6.6
Neutral
.11.3
10.2
What Others Might Think
Follow Advisories
Disagree
Percent
72.2
74.5
Don't Know
11.3
8.8
Fish Consumption Groups
Catch/Eat No
Listed Fish
Catch/Eat Listed
Fish Within
Limits
Eat Listed Fish
Above Limits
7.0 11.4 , 70.7
6.1 10.0 73.9
1.8 9.1 81.8
10.9
10.0
7.3
*Statistically significant difference between groups at P < .05 using Chi-
square test.
-------
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Table D-13. Respondents' perceptions about how informed they are regarding
health advisories and how easy it is to follow the
advisory-overall, by socio-demographic characteristics, state of
residence, advisory awareness, time of survey, and fish
consumption groups. ,
How Informed Are You About How Easy Is It to Follow
Safety of Eating Fish? Advisory Recommendations?*
Mean0 . Mean0
Overall 3.0 5.2
Age r
15-29 2.8e . 5.1
30-39 2.9e 5.0
40-49 3.2d 5.4
50+ 3.3d 5.3
Education
Grades 1-11 2.9 4.7
Grad. High School 3.1 5.1
Some College 3.0 5.2 _
Grad. College 3.1 5.8
Some Post Grad. 3.1 5.5
Income
< $20,000 3.0 4.8
$21,000-$34,000 3.0 5.1
$35,000-$50,000 3.1 - 5.4
> $51,000 3.2 5.6
Sex
Male 3.1d 5.2
Female 2.9e 4.8
•« *•«
Race - \
White 3.0 5.2
Other 3.0 5.3
Residence Area
Urban 3.1 5.2
Rural 3.0 5.1
State of Residence i
Pennsylvania 3.1 5.5
West Virginia 3.0 - 5.2
Kentucky 3.1 5.4d
Illinois 2.9 4.3*
Indiana 3.1 5.0 ~
Ohio 3.0 5.4d
Time of Survey
Spring '92 3.0
Fall '92 3.1
-------
147
Table D-13. (Cont.)
How Informed Are You About How Easy Is It to Follow
Safety of Eating Fish? Advisory Recommendations?8
Mean0 Mean0
Aware of Health Advisories
No 2.1e 4.4e
Generally Aware 2.7d>0 4.7°
Specifically Aware ,3.5d'f 5.5d'f
Fish Consumption Groups
Catch/Eat No Listed Fish 3.0 5.1
Catch/Eat Listed Fish
Within Limits 3.1 5.2
Eat Listed Fish Above Limits 3.1 4.8
'Question was asked on the fall survey only.
Measured on a scale where 5 = very well informed to 1 = not at all informed.
°Measured on a scale where 7 = very easy to 1 = very difficult.
d>eGroup d is statistically significantly higher than group e at P = .05 using
Scheffe's test and t-test where appropriate.
f'°Group f is statistically significantly higher than group g at P = .05 using
Scheffe's test or t-test where appropriate.
-------
148
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-------
150
Table D-15. Respondents' perceptions of whether they would eat small fish if
the advisory said only larger fish were unsafe-overall, by socio-
demographic characteristics, state of residence, advisory
awareness, time of survey, and fish consumption groups.
Overal1
Age
15-29
30-39
40-49
50+
Education
Grades 1-11
Grad. High School
Some College
Grad. College
Some Post Grad.
Income
< $20,000
• $21,000-$34,000
$35,000-$50,000
> $51,000
Sex
Male
Female
Race
White
Other
Residence Area
Urban
Rural
State of Residence
Pennsylvania
West Virginia
Kentucky
Illinois
Indiana
Ohio
Would Eat Small Fish
If Advisories Said Only Larger Fish Were Unsafe"
Agree Neutral Pisagree Don't Know
Percent
25.5
22.8
19.1
32.4
30.8
26.9
25.0
25.9
22.4
26.8
28.7
25.4
23.2
30.8
25.4
26.5
25.2
36.0
24.6
25.9
16.3
.5
.7
14,
25.
46.0
31.5
24.1
16.2
16.6
15.8
12.7
19.5
12.8
12.7
19.7
18.4
17.1
14.0
17,7
18.1
.15.4
16.1
17.6
16.3
4.0
17.4
15.4
16.3
12.4
15.
23,
18.
45.8
50.3
50.7
42.2
38.4
44.9
47.3
45.
53.
.2
.1
41.5
45.3
45.9
47.1
39.7
46.5
42.2
45.9
48.0
44.8
46.7
48.8
59.3
44.2
21,
43.
15.2
47.4
12.5
10.3
14.4
12.7
11.3
15.4
15.0
9.2
6.1
14.6
12.0
11.0
11.6
14.1
12.0
13.7
12.6
12.0
13.2
12.0
18.6*
13.8
14.7
9.2
6.5
13.3
-------
151
Table D-15. (Cont.)
Would Eat
If Advisories Said Only
Aware of Health Advisories
No
Generally Aware
Specifically Aware
Fish Consumption Groups
Catch/Eat No
Listed Fish
Catch/Eat Listed Fish
Within Limits
Eat Listed Fish
Above Limits
Agree
21.7
28.4
24.2
31.5
18.6
30.4
Neutral
Small Fish
Larger Fish
Disagree
Were Unsafe*
Don't Know
Percent
10.8
16.7
17.7
18.0
11.7
32.6
50.6
44.6
46.3
38.4
56.2
26.1
16.9
10.3
11.8
12.1*
13.5
10.9
Question was asked on fall survey only.
*Statistically significant difference between groups at P < .05 using Chi-
square test.
-------
152
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-------
154
Table D-17. Days fished the Ohio River in 1991-92 by residence area, state of
residence, and advisory awareness.
Davs Fished Ohio River in 1991-92
Residence Area
Urban
Rural
State of Residence
Pennsylvania
West Virginia
Kentucky
Illinois
Indiana
• Ohio
Aware of Health Advisory
No
Generally Aware
Specifically Aware
Mean
31.6
27.1
28.8
29.7
22.6
31.9
30.2
34.2
23.3
23.7"
33.6a
1-10 Davs
40.7
39.7
34.6
35.
50.
36.0
48.4
33.6
49.6
42.3
36.8
11-25 Davs
Percent
23.8
24.3
30.8
27.5
19.5
23.0
23.9
23.7
22.0
25.0
24.0
26+ Davs
35.5
36.0
34.6*
37.2
30.3
41.0
27.7
42.8
28.3*
32.7
39.2
*Statistically significant difference between groups at P < .05 using Chi-
square test.
a'bMean of group a is statistically significantly larger- than group b at P =
.05 using Scheffe's test.
-------
155
Table D-18. For those consuming listed fish, the average number of listed fish
meals and for those consuming unlisted fish, the average number of
unlisted fish meals-overall and by socio-demographic
characteristics, state of residence, timing of survey, advisory
awareness, days fished, and location fished most frequently.
For Those Consuming For Those Consuming
Listed Fish: Unlisted Fish:
Average Consumption Average Consumption
of Listed Fish of Unlisted Fish
Mean Meals/Year
Overall1
Age
15-29
30-39
40-49
50+
Education
Grades 1-11
Grad. High School
Some College
Grad. College
Some Post Grad.
Income
< $20,000
$21,000-$34,000
$35,000-$50,000
> $51,000
Sex
Male
Female
Race
White
Other
Residence Area
Urban
Rural
State of Residence
Pennsylvania
West Virginia
Kentucky
Illinois
Indiana
Ohio
10.7
5.8
6.7
13.1
22.6
8.7
14.0
4.4
a
a
17.1
5.0
9.4
12.2b
4.8C
10.9
13.3
8.8
12.8
0.0
16.3
15.3
16.4
16.5
16.9
19.8
14.3
16.9
19.2
19.4
17.1
15.8
13.9
16.3
16.5
15.1
33.7
16.0
16.6
14.2
15.0
19.8
13.6
17.0
-------
156
Table D-18. (Cont.)
For Those Consuming For Those Consuming
Listed Fish: Unlisted Fish:
Average Consumption Average Consumption
of Listed Fish of Unlisted Fish
Mean Meals/Year
Time of Survey
Spring '92 9.0 15.1
Fall '92 13.8 17.2
Aware of Advisories
No —* 21.2
Generally Aware 5.7 15.0
Specifically Aware 10.5 15.2
Total Days Fished
1-10 Days 2.7C 8.9C
11-25 Days 5.6K 14.8
26+ Days 20.9b 22.9b
Location Fished Most Frequently
Pittsburgh to Gallipolis
Greenup to McAlpine
Cannelton to Uniontown
Smith! and to Cairo
Don't Know
3.0
16.3
12.4
7.4
7.7
19.6
14.4
15.5
16.2
19.0
10verall mean fish consumption for all fish consumers was 19 meals/year of
Ohio River fish. Total consumption for a respondent consuming both listed
fish and unlisted fish is included in both columns of this table, partitioned
between listed fish consumption and unlisted fish consumption.
"Insufficient sample size.
b'°Group b is statistically significantly higher than group c at P = .05 using
Scheffe's test and t-test where appropriate.
-------
.157
Table D-19. Fish preparation methods used-overall and by fish consumption
groups.
Fish Preparation Methods
Risk-reducing
Remove fat along back
No meals
Few to most meals
All meals
Remove belly fat
No meals
Few to most meals
All meals
Remove skin ?.
No meals
Few to most meals
All meals
F/77et fish
No meals
Few to most meals
All meals
Bake, roast, broil or grill
No meals
Few to most meal s
All meals
Not Risk-reducing
fat whole fish
No meals
Few to most meals
All meals
Pan fry
No meals
Few to most meal s
All meals
Deep fry
No meals
Few to most meals
All meals
Overal 1
50.1
11.8
38.1
40.5
10.8
48.7
32.1
10.4
57.5
25.1
23.9
51.0
67.9
28.3
3.8
80.5
15.3
4.2
37.4
32.7
29.9
42.7
29.4
27.9
Fish
Catch/Eat No
Listed Fish
49.8
9.1
41.1
40.6
11.5
47.9
31.6
8.9
59.5
24.0
24.4
51.6
69.3
28.2
2.5
82.7
12.8
4.5
38.5
32.6
28.9
38.6
26.8
34.6
Consumption Grouos
Catch/Eat
Listed Fish
Within Limits
Percent
59.7
9.9
30.4
52.0
8.0
40.0
42.6
9.0
48.4
37.2
15.1
47.7
•
72.0
22.3
5.7
87.3
11.5
1.2
49.7
22.2
28.1
55.7
23.9
20.4
Eat Listed
Fish Above
Limits
31.0*
21.8
47.2
17.0*
14.8
68.2
11.8*
16.1
72.1
4.8*
35.6
59.6
60.7
34.8
4.5
70.1*
24.1
5.8
13.4*
52.6
34.0
24.7*
48.3
27.0
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Table D-19. (Cont.)
158
Fish Consumption Groups
FishPreparation Methods Overall
Catch/Eat Eat Listed
Catch/Eat No Listed Fish Fish Above
Listed Fish Within Limits Limits
Percent
Hake fish soup
No meals 96.1 97.5
Few to most meals 2.9 1.5
All meals 1.0 1.0
Microwave
No meals 95.0 93.0
Few to most meals 4.0 5.5
All meals 1.0 1.5
Reuse fish oil
No meals 83.7 79.8
Few to most meals 13.6 15.8
All meals 2.7 4.4
Other Methods
97.0
2.4
0.6
98.6
0.7
0.7
89.4
8.8
1.8
90.7
7.0
2.3
91.8
7.1
1.1
82.6
16.3
1.1
Freeze or can for later
No meals
Few to most meals
All meals
use
41.1
52.0
6.9
40.4
54.4
5.2
54.6
38.3
. 7.1
16.3*
71.7
12.0
*Statistically significant difference between consumption groups at P < .05
using Chi-square test.
-------
159
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-------
160
Table D-21. For respondents aware of the health advisory, the fish preparation
methods used by whether the respondent had changed cleaning or
cooking methods in response to the health advisory.
Fish Preparation Methods
Cleaning Methods
Remove Fat on Back
No Meals
Few to Most Meals
All Meals
Remove Belly Fat
No Meals
Few to Most Meals
All Meals
Remove Skin
No Meals
Few to Most Meals
All Meals
Eat Whole, Gutted Fish
No Meals
Few to Most Meals
. All Meals
Fillet
No Meals
Few to Most Meals
All Meals
Cooking Methods
Pan Fry
No Meals
Few to Most Meals
All Meals
Deep Fry
No Meals
Few 'to Most Meal s
All Meals
Hake Soup/Chowder
No Meals
Few to Most Meals
All Meals
Chanced Cleaning Method
Yes Other8
Percent
20.3
14.3
65.4
13.0
15.2
71.8
8.7
13.4
77.9
80.9
15.9
3.2
6.4
27.7
69.9
58.8*
11.8
29.4
47.1*
9.0
43.9
36.2*
10.6
53.2
78.7
16.4
4.9
27.1*
26.1
46.8
Changed Cooking Method
Yes Other"
Percent
23.1
50.7
26.2
23.8
42.9
33.3
93.5
4.9
1.6
34.6*
32.3
33.1
42.0*
29.7
28.3
96.1
3.0
0.9
-------
161
Table D-21. (Cont.)
Changed Cooking Method
Cookino Methods Yes other8 r
Percent '
Bake, Roast, Broil, Grill
No Meals
Few to Most Meal s
All Meals
Microwave
No Meals
Few to Most Meals
All Meals
Reuse Oil or Fat
No Meals
Few to Most Meals
All Meals
53.9
41.5
4.6
93.5
6.5
0.0
80.9
15.9
3.2
67.4
28.8
3.8
94.6
4.2
1.2
82.4
14.9
2.7
anOthern refers to respondents who said disagree, neutral, or don't know.
*Statistically significant difference between groups at P < .05 using Chi-
square test.
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162
Table D-22. Opinions about whether the health advisory has increased
respondents' interest in water pollution control and cleanup
efforts-overall, and by socio-demographic characteristics, state
of residence, time of survey, days fished, location fished, fish
consumption groups, and major sources of information.
Health Advisories Have Increased my Interest
in Pollution Control and Cleanup Efforts
Agree Neutral Disagree Don't Know
Percent
Overal1
Age
15-29
30-39
40-49
50+
Education
Grades 1-11
Grad. High School
Some College
Grad. College
Some Post Grad.
Income
< $20,000
$21,000-$34,000
$35,000-$50,000
> $51,000
Sex
Male
Female
Race
White
Other
Residence Area
Urban
Rural
State of Residence
Pennsylvania
West Virginia
Kentucky
Illinois
Indiana
Ohio
Time of Survey
Spring '92
Fall '92
63.7
54.9
62.9
65.6
73.2
60.9
64.7
63.8
59.0
64.8
64.2
63.5
62.4
66.7
65.2
57.5
63.5
61.9
64.3
62.9
14.9
17.6
15.2
13.6
12.1
14.1
14.0
15.9
13.3
20.3
15.2
15.3
14.3
16.3
14.7
15.5
15.2
9.5
14.7
15.2
59.3
61.1
69.7
62.7
67.2
59.4
10.2
12.2
12.5
20.9
14.5
18.0
62.6
64.6
15.9
14.2
12.5
17.6
11.9
12.1
7.9
12.5
11.3
13.0
16.9
10.8
11.3
12.7
14.3
9.2
11.7
16.0
12.5
14.3
12.8
12.5
16.9
16.2
12.1
5.5
11.8
12.1
13.1
11.9
8.9
9.9*
10.0
8.7
6.8
12.5
10.0
7.3
10.8
4.1
9.3
8.5
9.0
7.8
8.4
11.0
8.8
14.3
8.2
9.4
13.6*
10.5
5.7
10.9
6.5
10.5
8.4
9.3
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Table D-22. (Cont.)
163
Health Advisories Have Increased my Interest
Location Fished Most Frequently
Pittsburgh to Gallipolis
Greenup to McAlpine
Cannelton to Uniontown
Smith! and to Cairo
Don't Know
Fish Consumption Groups
Catch/Eat No Listed Fish
Catch/Eat Listed Fish
Within Limits
Eat Listed Fish Above Limits
Source of Information
Newspaper
.Fishing Regulations Guide
Posted Warnings
TV or Radio
Sources of Information
Newspaper
Fishing Regulations Guide
Posted Warnings
TV or Radio
Agree
62.5
64.5
75.9
62.8
55.3
61.7
65.8
70.0
70.3
68.5
57.8
68.7
3.6C
3.2
2.9
3.3°
Npnt.ral Disagree Don't Know
Percent
15.7 12.3
11.7 16.4
13.1 6.2
20.2 6.4
19.1 15.1
17.2 10.5
13.6 13.0
13.3 14.2
Percent Checked3
14.9 10.2
17.4 8.7
20.0 22.2
14.3 12.0
Mean Inroortance"
3.4 3.6
2.8 .2.9
2.8 2.7
3.3 3.3
9.5*
7m
.4
4.8
10.6
10.5
10.6*
7.6
2.5
4.6
5.4
0.0*
5.0
3.0°
2.5
2.3
2P*Q
.5
Question asked on the spring survey only. Respondents could check more than
one source of information.
"Question asked on the fall survey only. Importance was measured on a scale
where 5 = extremely important to 1 = not at all important.
c>dThe mean of group c is statistically significantly higher than group d at
P = .05 using Scheffe's test.
*Statistically significant difference between groups at P < .05 using Chi-
square test.
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