Treating People With Information: an Analysis and Review of Approaches to Communicating Health Risk Information

Rothman, Alexander J.; Kiviniemi, Marc T.

doi:10.1093/oxfordjournals.jncimonographs.a024207

Cited by 218 publications

(199 citation statements)

References 69 publications

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“…The four characteristics included in this study were: 1) route of administration, 2) absolute risk reduction of vertebral fractures over five years, 3) absolute risk reduction of hip fractures over five years, and 4) risk of adverse effects. Risk information was presented using natural frequencies and pictographs to facilitate communication of probabilistic data [28,29]. Medication characteristics were first explained in detail to participants using lay terminology and then, because of space constraints, presented in abbreviated format in the computerized questionnaire.…”

Section: Preference Measurementmentioning

confidence: 99%

Patient willingness to take teriparatide

Fraenkel

Wittink

2007

Patient Education and Counseling

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Objectives- ] is an effective treatment for osteoporosis administered by daily subcutaneous injection. The objective of this study was to determine how much benefit women expect teriparatide to confer before agreeing to perform daily injections.Methods-We recruited postmenopausal women who had recently undergone bone densitometry and were found to have either a T score less than −2.5 at the hip or spine and/or had a Fracture Index (FI) of ≥ 6. Participants completed an Adaptive Conjoint Analysis questionnaire to determine their treatment preferences.Results-The study sample included 185 women, mean age 71 (range 46 to 90). An increasing number of subjects preferred rhPTH (1-34) as the efficacy of teriparatide increased, but most women demanded efficacy advantages greater than those demonstrated in clinical studies. We found no association between absolute fracture risk and preference for rhPTH (1-34); however, subjects with an excessively high perceived risk of future fracture were more likely to accept daily subcutaneous injections compared to subjects with a lower perceived risk of future fracture (40% versus 15%, p=0.001).Conclusions-Our results suggest that most women demand benefits far greater than those conferred by rhPTH (1-34) in order to administer daily subcutaneous injections to decrease their future risk of fractures.Practice Implications-Given the poor adherence for treatment of osteoporosis, and the choices older adults must make when paying for medications, development of novel treatment approaches should be based on older adults' treatment preferences.

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Section: Preference Measurementmentioning

confidence: 99%

Patient willingness to take teriparatide

Fraenkel

Wittink

2007

Patient Education and Counseling

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“…This is important for promoting appropriate precautionary behaviors, for plan-ning health promotion, and also for avoiding societal and economic disruption related to epidemic and pandemic threats. We know that risk perceptions reflect a broader set of cognitive and affective beliefs than simply estimations of the likelihood of an event [8], and that people's judgments are based on the availability bias and heuristic processing using easily available cues [9]. Research on perceptions and behaviors related to infectious diseases in general, and to pandemics in special, has not yet developed its theoretical basis in the same sense that it has been done in the area of chronic, lifestyle diseases.…”

Section: Introductionmentioning

confidence: 99%

Willingness to Take Travel-Related Health Risks—A Study among Finnish Tourists in Asia during the Avian Influenza Outbreak

Aro

Vartti²,

Schreck³

et al. 2009

Int.J. Behav. Med.

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Background Health risk perception and behavior of tourists during epidemics is a challenge for behavioral medicine.Purpose The purpose was to analyze associations of psychosocial factors and willingness to take health risks on holiday and business trips. Method Subjects (survey n=338) were Finnish tourists visiting South-East Asia during the avian influenza epidemic of 2004. On holidays, 13.8%, and on business trips, 6.3% would take (rather) high risks, 14.1% reported having tendency to take health risks. Willingness to take health risks on both kinds of trips was lower among those +40 years old than those <40. Comparatively high risk-taking tendency and high perceived HIV risk were related to the increased willingness to take health risks on both kinds of trips. Results On holidays, willingness to take health risks was related to trust in fate, and on business trips, this was also related to trust in God and less precautionary behavior of avoiding hand shaking, but also to higher estimation of other risks in life. Conclusion Younger travelers and those on holidays are willing to take more health risks than those who are older or on business trips. Travel advice during epidemics could be differentially targeted to different age groups and to holiday and business travelers.

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“…For each study, increasing understanding (e.g., risks of using anabolic steroids, knowledge about risks of diet pills, and reasons for eating fruits and vegetables) was a mediator of positive behavioral outcomes. This differs from the common wisdom that knowledge-based programs do not impact actions [43][44][45]. For some programs where baseline knowledge is high, such as consequences of tobacco and alcohol use, there may be little room for improvement [46].…”

Section: Discussionmentioning

confidence: 93%

Empiric validation of a process for behavior change

Elliot

Goldberg

MacKinnon

et al. 2015

Behav. Med. Pract. Policy Res.

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Most behavior change trials focus on outcomes rather than deconstructing how those outcomes related to programmatic theoretical underpinnings and intervention components. In this report, the process of change is compared for three evidence-based programs' that shared theories, intervention elements and potential mediating variables. Each investigation was a randomized trial that assessed pre-and post-intervention variables using survey constructs with established reliability. Each also used mediation analyses to define relationships. The findings were combined using a pattern matching approach. Surprisingly, knowledge was a significant mediator in each program (a and b path effects [p<0.01]). Norms, perceived control abilities, and self-monitoring were confirmed in at least two studies (p<0.01 for each). Replication of findings across studies with a common design but varied populations provides a robust validation of the theory and processes of an effective intervention. Combined findings also demonstrate a means to substantiate process aspects and theoretical models to advance understanding of behavior change. KeywordsBehavior change, Mediation, Peer-led INTRODUCTION Knowledge about how healthy lifestyles can prevent illness has outpaced effective means to assist people in living health lives [1]. That limitation is not due to lack of research, and contributions have come from diverse disciplines, such as health promotion, behavioral economics, psychology, decision analysis, and sociology. However, progress may have been constrained due to a focus on outcomes rather than deconstructing how change occurred [2][3][4]. Our group has studied a series of behavior change interventions that use a shared format and theoretical structure. All had documented efficacy in randomized controlled trials [5][6][7][8][9][10], and for each, specific program components were related to behavioral endpoints [11][12][13]. Comparing their observed patterns of findings presents a means to assess theories of behavior change and validate an effective intervention format.

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Treating People With Information: an Analysis and Review of Approaches to Communicating Health Risk Information

Cited by 218 publications

References 69 publications

Patient willingness to take teriparatide

Patient willingness to take teriparatide

Willingness to Take Travel-Related Health Risks—A Study among Finnish Tourists in Asia during the Avian Influenza Outbreak

Empiric validation of a process for behavior change

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