Understanding risk perceptions and responses of the public, healthcare professionals and the media
: the case of Clostridium difficile

  • Emma Jane Burnett

    Student thesis: Doctoral ThesisDoctor of Philosophy


    My original contribution to knowledge is the emergence of an inductively derived conceptual framework that provides a generic account of the way in which people construct and communicate risk. Within this framework, a detailed contextual understanding of how this was applied to C.difficile is developed. Furthermore, in seeking to place responses to health risks in the wider social, cultural and political context, moving beyond a standard critique of media output, an understanding of both how and why the media report health-related risks helped identify ways in which the media can influence how people can construct and communicate about risks.

    The incidence and severity of C.difficile infection is increasing and it is one of the most common healthcare associated infections, posing a global threat to public health. With the occurrence of major outbreaks within the UK and elsewhere, fear, confusion and unsafe infection prevention and control practices continue to exist among the public and healthcare professionals. Consequently, C.difficile is of particular interest to the media, being the focus of much media reporting.

    How the public perceive and respond to a health-related risk is shaped by a range of socially and contextually structured evaluations and interpretations, based on a range of factors such as availability heuristics, direct and indirect experiences and social influences, particularly those emanating from the media. Expert risk perceptions and responses on the other hand, are sometimes supposed to be more veridical than those of the public because they are based on calculations of scientific probabilities. Risk perceptions and responses however are context dependent and therefore to be understood, need to be considered within the context that they are perceived and experienced. There is currently little risk perception empirical research to draw upon within the context of C.difficile.

    The aim of this study was to explore risk perceptions and responses of the public and healthcare professionals within the context of C.difficile and to examine the role of the media in health-related risk reporting. This qualitative study adopted three approaches to data collection: a media coverage analysis of a major C.difficile outbreak, focus groups with the public and healthcare professionals in two geographical areas (an outbreak versus a non-outbreak area), and in-depth, semi-structured interviews with media professionals.

    The media coverage analysis found that the media portrayed key individuals involved in the outbreak as victims, villains and heroes. These ‘characters’ evolved as the outbreak progressed and new information became available. Such representations were frequently used as a backdrop for the public and healthcare professionals in order to support or refute their perceptions about C.difficile.

    For the public and healthcare professionals, the consequence of C.difficile and why it occurred was much more salient than estimations of the probability or likelihood of it occurring. Conceptual factors that were found to be important in influencing perceptions included: feelings of vulnerability; attribution of responsibility; judgements about competence; and evaluations of risk communicators.

    Media professionals were seen as important risk communicators in the focus groups, however they saw themselves as predominantly story tellers and entertainers, rather than ‘educators’. They also believed themselves to be advocates for the public whereby they uncover information that officialdom would seek to keep hidden.

    What emerged from this study was a coherent, structured and generic account of how various stakeholders construct and communicate about risk. Within this conceptual structuring, a detailed contextual understanding of how this was applied by the public and healthcare professionals around C.difficile was gained. Findings indicate that uncertainty, fear and confusion about C.difficile exist that appear to be influenced by a range of contextual factors such as indirect and direct experiences, social interaction and the media. If risk management and communication strategies are to influence the desired and effective responses towards C.difficile and wider health-related risks, those responsible for managing and communicating risk must consider already established risk perceptions in addition to the factors that have influenced such risk perceptions.
    Date of Award2015
    Original languageEnglish
    SupervisorHuw Davies (Supervisor) & Joanne Corlett (Supervisor)


    • Clostridium difficile
    • Risk
    • Risk perceptions
    • Risk communication
    • Healthcare associated infections

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