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8. Using Separate Single-Outcome Risk Presentations Instead of Integrated Multioutcome Formats Improves Comprehension in Discrete Choice Experiments.

Author

Wallace, Matthew J., Weissler, E. Hope, Yang, Jui-Chen, Brotzman, Laura, Corriere, Matthew A., Secemsky, Eric A., Sutphin, Jessie, Johnson, F. Reed, Marcos Gonzalez, Juan, Tarver, Michelle E., Saha, Anindita, Chen, Allen L., Gebben, David J., Malone, Misti, Farb, Andrew, Babalola, Olufemi, Rorer, Eva M., Zikmund-Fisher, Brian J., and Reed, Shelby D.

Abstract

Introduction: Despite decades of research on risk-communication approaches, questions remain about the optimal methods for conveying risks for different outcomes across multiple time points, which can be necessary in applications such as discrete choice experiments (DCEs). We sought to compare the effects of 3 design factors: 1) separated versus integrated presentations of the risks for different outcomes, 2) use or omission of icon arrays, and 3) vertical versus horizontal orientation of the time dimension. Methods: We conducted a randomized study among a demographically diverse sample of 2,242 US adults recruited from an online panel (mean age 59.8 y, s = 10.4 y; 21.9% African American) that compared risk-communication approaches that varied in the 3 factors noted above. The primary outcome was the number of correct responses to 12 multiple-choice questions asking survey respondents to identify specific numbers, contrast options to recognize dominance (larger v. smaller risks), and compute differences. We used linear regression to test the effects of the 3 design factors, controlling for health literacy, graph literacy, and numeracy. We also measured choice consistency in a subsequent DCE choice module Results: Mean comprehension varied significantly across versions (P < 0.001), with higher comprehension in the 3 versions that provided separated risk information for each risk. In the multivariable regression, separated risk presentation was associated with 0.58 more correct responses (P < 0.001; 95% confidence interval: 0.39, 0.77) compared with integrated risk information. Neither providing icon arrays nor using vertical versus horizontal time formats affected comprehension rates, although participant understanding did correlate with DCE choice consistency. Conclusions: In presentations of multiple risks over multiple time points, presenting risk information separately for each health outcome appears to increase understanding. Highlights: When conveying information about risks of different outcomes at multiple time points, separate presentations of single-outcome risks resulted in higher comprehension than presentations that combined risk information for different outcomes. We also observed benefits of presenting single-outcome risks separately among respondents with lower numeracy and graph literacy. Study participants who scored higher on risk understanding were more internally consistent in their responses to a discrete choice experiment. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Standardizing return of participant results

Author

Botkin, Jeffrey R., Appelbaum, Paul S., Bakken, Suzanne, Brown, Chester, Burke, Wylie, Fabsitz, Richard, Gamble, Vanessa Northington, Gonsalves, Gregg, Kost, Rhonda, Leonard, Debra G. B., McGuire, Amy, Nichols, James H., Patrick-Lake, Bray, Wilkins, Consuelo H., and Zikmund-Fisher, Brian J.

Published
2018

13. “Cure” Versus “Clinical Remission”: The Impact of a Medication Description on the Willingness of People Living with HIV to Take a Medication

Author

Fridman, Ilona, Ubel, Peter A., Blumenthal-Barby, Jennifer, England, Cameron V., Currier, Judith S., Eyal, Nir, Freedberg, Kenneth A., Halpern, Scott D., Kelley, Colleen F., Kuritzkes, Daniel R., Le, Catherine N., Lennox, Jeffrey L., Pollak, Kathryn I., Zikmund-Fisher, Brian J., and Scherr, Karen A.

Published
2020
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15. Do you want to promote recall, perceptions, or behavior? The best data visualization depends on the communication goal.

Author

Ancker, Jessica S, Benda, Natalie C, and Zikmund-Fisher, Brian J

Abstract

Data visualizations can be effective and inclusive means for helping people understand health-related data. Yet numerous high-quality studies comparing data visualizations have yielded relatively little practical design guidance because of a lack of clarity about what communicators want their audience to accomplish. When conducting rigorous evaluations of communication (eg, applying the ISO 9186 method), describing the process simply as evaluating "comprehension" or "interpretation" of visualizations fails to do justice to the true range of outcomes being studied. We present newly developed taxonomies of outcome measures and tasks that are guiding a large-scale systematic review of the health numbers communication literature. Using these taxonomies allows a designer to determine whether a specific data presentation format or feature supports or inhibits the desired audience cognitions, feelings, or behaviors. We argue that taking a granular, outcomes-based approach to designing and evaluating information visualization research is essential to deriving practical, actionable knowledge from it. [ABSTRACT FROM AUTHOR]

Published
2024
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25. Prior Vaccination and Effectiveness of Communication Strategies Used to Describe Infectious Diseases

Author

Valley, Thomas S., Scherer, Aaron M., Knaus, Megan, Zikmund-Fisher, Brian J., Das, Enny, and Fagerlin, Angela

Subjects
Influenza vaccines -- Analysis, Communicable diseases -- Analysis, Public health -- Analysis, Influenza -- Analysis, Vaccination -- Analysis, Health care reform -- Analysis, Medical schools, Organizational communication, Physicians, Europeans, Immunotherapy, Health
Abstract

Vaccination rates for influenza remain surprisingly low (1). Despite goals to vaccinate 75% of high-risk Europeans by 2010, Improving communication strategies that clinicians and healthcare organizations use to increase vaccination [...]

Published
2019

26. Perceived Barriers Among Clinicians and Older Adults Aged 65 and Older Regarding Use of Life Expectancy to Inform Cancer Screening: A Narrative Review and Comparison.

Author

Brotzman, Laura E. and Zikmund-Fisher, Brian J.

Subjects
*LIFE expectancy, *OLDER people, *EARLY detection of cancer, *MEDICAL personnel, *MEDICAL screening
Abstract

While cancer screening guidelines increasingly recommend incorporating life expectancy estimates to inform screening decisions for older adults, little is known about how this happens in practice. This review summarizes current knowledge about primary care clinician and older adult (65+) perspectives about use of life expectancy to guide cancer screening decisions. Clinicians report operational barriers, uncertainty, and hesitation around use of life expectancy in screening decisions. They recognize it may help them more accurately weigh benefits and harms but are unsure how to estimate life expectancy for individual patients. Older adults face conceptual barriers and are generally unconvinced of the benefits of considering their life expectancy when making screening decisions. Life expectancy will always be a difficult topic for clinicians and patients, but there are advantages to incorporating it in cancer screening decisions. We highlight key takeaways from both clinician and older adult perspectives to guide future research. [ABSTRACT FROM AUTHOR]

Published
2023
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41. The Lancet Breast Cancer Commission: tackling a global health, gender, and equity challenge

Author

Abraham, Jean E, Anderson, Benjamin O, André, Fabrice, Barrios, Carlos H, Bliss, Judith M, Boughey, Judy C, Cameron, David A, Cardoso, Fatima V, Carey, Lisa A, Chatterjee, Sanjoy, Coles, Charlotte E, Cuzick, Jack, Du Plooy, Dorothy, Francis, Prudence A, Gralow, Julie R, Jagsi, Reshma, Knaul, Felicia M, Ma, Fei, Mann, Ritse M, McIntosh, Stuart A, Mertz, Shirley A, Mutebi, Miriam, Olopade, Funmi, Phillips, Kelly-Anne, Poortmans, Philip M, Spanic, Tanja, Spence, Dingle, Stobart, Hilary, Symmans, Fraser WF, Villarreal-Garza, Cynthia, Yip, Cheng-Har, Bienz, Maya J, Drewett, Lynsey M, Fulton, Alex, Inbah Rajah, Dharrnesha, Kazmi, Farasat, Rubasingham, Jeffrey, Thompson, Mareike, Vargas, Valentina, Arreola, Hector, Badwe, Raj A, Calderon Anyosa, Renzo JC, Dave, Rajiv V, De-Graft Aikins, Ama, Earl, Helena M, Essue, Beverley M, Etzioni, Ruth B, Hawley, Sarah T, Jiang, Xiaoxiao, Mittra, Indraneel, Moreno, Patricia I, Nargund, Renu Sara, Noble, Cara, Smith, Robert A, Verhoeven, Didier, Wang, Jiani N, Watkins, David A, Zikmund-Fisher, Brian J, Coles, Charlotte Elizabeth, Cameron, David, Cardoso, Fatima, Horton, Richard, Knaul, Felicia Marie, and Lee, Naomi

Published
2022
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43. Discussion of average versus extreme case severity in pandemic risk communications

Author

Zikmund-Fisher, Brian J., Scherer, Aaron M., Knaus, Megan, Das, Enny, and Fagerlin, Angela

Subjects
Epidemics -- Risk factors -- Research -- Netherlands, Influenza -- Educational aspects -- Research, Perception (Psychology) -- Research, Health
Abstract

When pandemics strike, clear and timely communication is essential to raising public awareness of disease threat and motivating preventive behaviors (1). Yet, in most pandemics, the experience of affected persons [...]

Published
2017

46. Taxonomies for synthesizing the evidence on communicating numbers in health: Goals, format, and structure.

Author

Ancker, Jessica S., Benda, Natalie C., Sharma, Mohit M., Johnson, Stephen B., Weiner, Stephanie, and Zikmund‐Fisher, Brian J.

Subjects
TAXONOMY, NUMERACY
Abstract

Many people, especially those with low numeracy, are known to have difficulty interpreting and applying quantitative information to health decisions. These difficulties have resulted in a rich body of research about better ways to communicate numbers. Synthesizing this body of research into evidence‐based guidance, however, is complicated by inconsistencies in research terminology and researcher goals. In this article, we introduce three taxonomies intended to systematize terminology in the literature, derived from an ongoing systematic literature review. The first taxonomy provides a systematic nomenclature for the outcome measures assessed in the studies, including perceptions, decisions, and actions. The second taxonomy is a nomenclature for the data formats assessed, including numbers (and different formats for numbers) and graphics. The third taxonomy describes the quantitative concepts being conveyed, from the simplest (a single value at a single point in time) to more complex ones (including a risk‐benefit trade‐off and a trend over time). Finally, we demonstrate how these three taxonomies can be used to resolve ambiguities and apparent contradictions in the literature. [ABSTRACT FROM AUTHOR]

Published
2022
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