Examining the Relationship Between Perceived Ambiguity and Predictors of Health Behavior Across Three Contexts: The COVID-19 Pandemic, Antibiotic Regimens, and e-Cigarette Use

Ambiguity can elicit ambiguity aversion, or avoidance behavior, which is theoretically expected to occur because of a pessimistic interpretation of information (e.g. about risk) and from low perceived personal competence. Emotion may also play a role in how people respond to ambiguity, although little research has examined the role of emotion. The purpose of this research is to examine support for theoretical frameworks of ambiguity aversion and the role of emotion in responses to ambiguity. To do so, we tested (1) whether risk perceptions, perceived competence, and self-efficacy mediated the relationship between ambiguity and behavioral avoidance, and (2) whether fear and anger mediated the relationship between ambiguity and risk perceptions. Three online experiments were conducted across three health contexts - COVID-19, antibiotic regimens, and e-cigarettes. Across experiments, participants were randomly assigned to read an ambiguous or unambiguous health message relevant to the health context. Next, participants completed a survey of measures relevant to study aims. Based on the results of mediation analyses, one significant pattern of results emerged across two of three experiments: ambiguity led to lower behavioral intentions, consistent with behavioral avoidance. However, there was no consistent pattern of results across all three experiments to support the competence hypothesis or pessimistic appraisal as an explanation for this behavioral avoidance. In Experiment 2 only, there was some support for the competence hypothesis, but there was no support across any of the three experiments for pessimistic appraisal. As for the role of emotion in responses to ambiguity, anger (in Experiments 2 and 3) and fear (in Experiment 3) mediated the relationship between ambiguity and risk perception (i.e. perceived susceptibility and worry), but the direction of these effects was inconsistent with hypotheses. Overall, the results of the present research demonstrate that ambiguity can lead to behavioral avoidance, although the mechanisms remain unclear. Motivated reasoning may provide one explanation for the pattern of results. Findings have implications for health behavior interventions when ambiguity is experienced.