Use of Emotional Response Modeling to Develop More Effective Risk Communication for Limited Literacy Adults: Evaluation of a "Dirty Bomb" Decision Aid.

Behavioral, attitudinal, and emotional reactions to terrorism can be minimized by communication that promotes successful response through preparedness. However, a challenge to adequate preparedness is the substantial proportion of adults with "below basic" or "basic" literacy skills and how this affects development of health messages. This research explored whether a non-verbal emotional measurement and modeling technique (AdSAM®) can be used with a limited literacy population to support the development of message strategies for disaster situations such as a "dirty bomb" terror event. Adults with limited literacy were randomly assigned to review either a standard CDC decision aid written at a 9 grade level (n=22) or an adapted aid written at a 6 grade level (n=28). Using the AdSAM® emotional response instrument, participants answered questions regarding their feelings about a 'dirty bomb'. The group shown the adaptive aid had more positive emotional responses, including less arousal and greater empowerment. The AdSAM® approach can provide researchers with insights into the design of tailored messages for a limited literacy population in high risk, high-emotion situations.