Dataset Information

Risk Ladder, Table, or Bulleted List? Identifying Formats That Effectively Communicate Personalized Risk and Risk Reduction Information for Multiple Diseases.

ABSTRACT:

Background

Personalized medicine may increase the amount of probabilistic information patients encounter. Little guidance exists about communicating risk for multiple diseases simultaneously or about communicating how changes in risk factors affect risk (hereafter "risk reduction").

Purpose

To determine how to communicate personalized risk and risk reduction information for up to 5 diseases associated with insufficient physical activity in a way laypeople can understand and that increases intentions.

Methods

We recruited 500 participants with <150 min weekly of physical activity from community settings. Participants completed risk assessments for diabetes, heart disease, stroke, colon cancer, and breast cancer (women only) on a smartphone. Then, they were randomly assigned to view personalized risk and risk reduction information organized as a bulleted list, a simplified table, or a specialized vertical bar graph ("risk ladder"). Last, they completed a questionnaire assessing outcomes. Personalized risk and risk reduction information was presented as categories (e.g., "very low"). Our analytic sample (N = 372) included 41.3% individuals from underrepresented racial/ethnic backgrounds, 15.9% with vocational-technical training or less, 84.7% women, 43.8% aged 50 to 64 y, and 71.8% who were overweight/obese.

Results

Analyses of covariance with post hoc comparisons showed that the risk ladder elicited higher gist comprehension than the bulleted list (P = 0.01). There were no significant main effects on verbatim comprehension or physical activity intentions and no moderation by sex, race/ethnicity, education, numeracy, or graph literacy (P > 0.05). Sequential mediation analyses revealed a small beneficial indirect effect of risk ladder versus list on intentions through gist comprehension and then through perceived risk (b_{IndirectEffect} = 0.02, 95% confidence interval: 0.00, 0.04).

Conclusion

Risk ladders can communicate the gist meaning of multiple pieces of risk information to individuals from many sociodemographic backgrounds and with varying levels of facility with numbers and graphs.

SUBMITTER: Waters EA

PROVIDER: S-EPMC7772263 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Risk Ladder, Table, or Bulleted List? Identifying Formats That Effectively Communicate Personalized Risk and Risk Reduction Information for Multiple Diseases.

Waters Erika A EA Maki Julia J Liu Ying Y Ackermann Nicole N Carter Chelsey R CR Dart Hank H Bowen Deborah J DJ Cameron Linda D LD Colditz Graham A GA

Medical decision making : an international journal of the Society for Medical Decision Making 20201026 1

<h4>Background</h4>Personalized medicine may increase the amount of probabilistic information patients encounter. Little guidance exists about communicating risk for multiple diseases simultaneously or about communicating how changes in risk factors affect risk (hereafter "risk reduction").<h4>Purpose</h4>To determine how to communicate personalized risk and risk reduction information for up to 5 diseases associated with insufficient physical activity in a way laypeople can understand and that i ...[more]

PMID: 33106087

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Project description:BackgroundThe promise of precision medicine could be stymied if people do not accept the legitimacy of personalized risk information. We tested 4 explanations for skepticism of personalized diabetes risk information.MethodWe recruited participants (N = 356; Mage = 48.6 [s = 9.8], 85.1% women, 59.0% non-Hispanic white) from community locations (e.g., barbershops, churches) for a risk communication intervention. Participants received personalized information about their risk of developing diabetes and heart disease, stroke, colon cancer, and/or breast cancer (women). Then they completed survey items. We combined 2 items (recalled risk, perceived risk) to create a trichotomous risk skepticism variable (acceptance, overestimation, underestimation). Additional items assessed possible explanations for risk skepticism: 1) information evaluation skills (education, graph literacy, numeracy), 2) motivated reasoning (negative affect toward the information, spontaneous self-affirmation, information avoidance); 3) Bayesian updating (surprise), and 4) personal relevance (racial/ethnic identity). We used multinomial logistic regression for data analysis.ResultsOf the participants, 18% believed that their diabetes risk was lower than the information provided, 40% believed their risk was higher, and 42% accepted the information. Information evaluation skills were not supported as a risk skepticism explanation. Motivated reasoning received some support; higher diabetes risk and more negative affect toward the information were associated with risk underestimation, but spontaneous self-affirmation and information avoidance were not moderators. For Bayesian updating, more surprise was associated with overestimation. For personal relevance, belonging to a marginalized racial/ethnic group was associated with underestimation.ConclusionThere are likely multiple cognitive, affective, and motivational explanations for risk skepticism. Understanding these explanations and developing interventions that address them will increase the effectiveness of precision medicine and facilitate its widespread implementation.

Project description:Despite widespread evidence that nonverbal components of human speech (e.g., voice pitch) communicate information about physical attributes of vocalizers and that listeners can judge traits such as strength and body size from speech, few studies have examined the communicative functions of human nonverbal vocalizations (such as roars, screams, grunts and laughs). Critically, no previous study has yet to examine the acoustic correlates of strength in nonverbal vocalisations, including roars, nor identified reliable vocal cues to strength in human speech. In addition to being less acoustically constrained than articulated speech, agonistic nonverbal vocalizations function primarily to express motivation and emotion, such as threat, and may therefore communicate strength and body size more effectively than speech. Here, we investigated acoustic cues to strength and size in roars compared to screams and speech sentences produced in both aggressive and distress contexts. Using playback experiments, we then tested whether listeners can reliably infer a vocalizer's actual strength and height from roars, screams, and valenced speech equivalents, and which acoustic features predicted listeners' judgments. While there were no consistent acoustic cues to strength in any vocal stimuli, listeners accurately judged inter-individual differences in strength, and did so most effectively from aggressive voice stimuli (roars and aggressive speech). In addition, listeners more accurately judged strength from roars than from aggressive speech. In contrast, listeners' judgments of height were most accurate for speech stimuli. These results support the prediction that vocalizers maximize impressions of physical strength in aggressive compared to distress contexts, and that inter-individual variation in strength may only be honestly communicated in vocalizations that function to communicate threat, particularly roars. Thus, in continuity with nonhuman mammals, the acoustic structure of human aggressive roars may have been selected to communicate, and to some extent exaggerate, functional cues to physical formidability.

Dataset Information

Risk Ladder, Table, or Bulleted List? Identifying Formats That Effectively Communicate Personalized Risk and Risk Reduction Information for Multiple Diseases.

Background

Purpose

Methods

Results

Conclusion

Publications

Risk Ladder, Table, or Bulleted List? Identifying Formats That Effectively Communicate Personalized Risk and Risk Reduction Information for Multiple Diseases.

Similar Datasets

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