Raluca Cozmuta1, Evan Wilhelms2, Diana Cornell3, Julia Nolte4, Valerie Reyna4, Liana Fraenkel5. 1. Emory University School of Medicine, Atlanta, Georgia. 2. The College of Wooster, Wooster, Ohio. 3. Yale University School of Medicine, New Haven, Connecticut. 4. Cornell University, Ithaca, New York. 5. Yale University School of Medicine, New Haven, Connecticut, and VA Connecticut Healthcare System, West Haven, Connecticut.
Abstract
OBJECTIVE: The aim of this study was to examine whether providing patients with a series of balance scales (BS), depicting a reciprocal relationship between achieving disease control and increasing the risk of infection, influences treatment preference. METHODS: Participants were randomized to receive a description of a medication in which risk of infection was relayed using 1 of 4 formats, including numbers only, numbers + icon array (IA), numbers + BS, or numbers + IA + BS (i.e., combination). We compared the likelihood of starting the medication across the 4 formats, and evaluated whether the influence of risk formats varied by numeracy and gist risk appraisals. RESULTS: The mean ± SE likelihood of starting the medication was higher among participants randomized to the combination format (3.85 ± 0.09) compared to those who viewed the BS (3.56 ± 0.09; P = 0.0222) or numbers-only formats (3.51 ± 0.09; P = 0.0069). Viewing an IA alone was associated with a lower likelihood of starting the medication among participants lower in numeracy and endorsing a risk-avoidant noncompensatory gist risk appraisal. Conversely, viewing an IA (with or without the BS) was associated with a greater likelihood of starting the medication among patients with higher numeracy and compensatory risk appraisals. CONCLUSION: Adding explanatory images to IAs increases patient likelihood to take a medication in those with low numeracy and a noncompensatory gist risk appraisal. Explanatory images may be a feasible approach to improve willingness to try medication among subjects who are especially risk averse and believe that any risk is unacceptable.
RCT Entities:
OBJECTIVE: The aim of this study was to examine whether providing patients with a series of balance scales (BS), depicting a reciprocal relationship between achieving disease control and increasing the risk of infection, influences treatment preference. METHODS:Participants were randomized to receive a description of a medication in which risk of infection was relayed using 1 of 4 formats, including numbers only, numbers + icon array (IA), numbers + BS, or numbers + IA + BS (i.e., combination). We compared the likelihood of starting the medication across the 4 formats, and evaluated whether the influence of risk formats varied by numeracy and gist risk appraisals. RESULTS: The mean ± SE likelihood of starting the medication was higher among participants randomized to the combination format (3.85 ± 0.09) compared to those who viewed the BS (3.56 ± 0.09; P = 0.0222) or numbers-only formats (3.51 ± 0.09; P = 0.0069). Viewing an IA alone was associated with a lower likelihood of starting the medication among participants lower in numeracy and endorsing a risk-avoidant noncompensatory gist risk appraisal. Conversely, viewing an IA (with or without the BS) was associated with a greater likelihood of starting the medication among patients with higher numeracy and compensatory risk appraisals. CONCLUSION: Adding explanatory images to IAs increasespatient likelihood to take a medication in those with low numeracy and a noncompensatory gist risk appraisal. Explanatory images may be a feasible approach to improve willingness to try medication among subjects who are especially risk averse and believe that any risk is unacceptable.