Strengthening next generation risk decision-making: A contemporary review

Risk decision-making inherently requires consideration of fundamental principles and other factors pertinent for addressing important health and environmental risks of concern. The risk decision-making process has evolved from linear frameworks to more integrated and dynamic strategies. A recent scoping review mapped this evolution and demonstrated a transition to more holistic and complex approaches. The term next generation risk decision-making captures these contemporary strategies by incorporating all aspects of risk assessment, management, and communication involved in risk decision-making, thereby going beyond recently articulated next generation risk assessment frameworks. While this scoping review included best practices and ten attributes of risk decision-making, it did not address how to consider these factors when developing strategies for next generation risk decision-making. This contemporary review addresses this limitation by discussing the role of decision theories prior to presenting a model for characterizing, categorizing, and visualizing these ten considerations: foresight and planning, research and development, regulatory, risk, upstream and downstream attributes, risk culture, ONE Health lens, broad regulatory factors, risk management, and risk communication. The realist paradigm-based model and corresponding considerations are then analyzed using a strengths, weaknesses, opportunities, and threats analysis of top-down, bottom-up, and fully integrated risk science strategies to next generation risk decision-making.