Disease Cause Attribution and Health- Related Judgments: A Self-Control View.

Research Question This research investigates how attribution of a disease to lifestyle versus genetic causes influences consumers' medical decision-making. As patients play more active roles in health related decisions, it is important to understand how consumers make decisions when a disease is attributed to different causes. Our understanding the role of genes as a risk factor in the development of various diseases has improved substantially in recent decades, and a growing number of hospitals now offer genetic risk counseling. This research contributes to emerging literature on patients' response to genetic medical information by investigating the role of the level of self-control in the response to diseases cause attribution. The ability to override impulses and persist on long-term goals, in other words exhibiting high level of self-control, is an important component for success in many health-related interventions. Understanding the relationship between individual differences in self-control level and response to attribution of diseases will help create more targeted health communications for consumers. Method and Data Two scenario-based studies were conducted. In study 1, we recruited 105 participants at a student union of a large public university. Participants first read a brief description of diabetes. Next, they read a scenario that described a person who has exhibited symptoms that could be consistent with diabetes. Participants then received one of the two attribution (genetic vs. lifestyle) frames of the symptoms. Next they indicated the likelihood of developing diabetes and the blame for developing diabetes from the perspective of the person in the scenario. In the end, the self-control trait was measured with scale developed by Tangney, Baumeister, and Boone (2004). In study 2, we recruited 202 participants from online panel with broad demographic representation. Participants completed a similar survey to study 1 using heart disease as a focal disease. In addition to answering likelihood of developing disease, blame for developing disease, and the self-control trait measures, participants were asked to indicate how they would allocate $500 of the FSA (flexible spending account) among six different health-care options (screening test at the hospital, co-pay for medications, gym membership, co-pay for doctor's visits, membership fee for patient support group, and nutrition specialist consultation). Summary of Findings A series of regression analyses were conducted using the self-control level, the attribution condition, and interaction of these two factors as independent variables. Across two studies, an analysis of likelihood of developing disease revealed that the likelihood did not significantly differ between the two attribution conditions among participants with higher self-control, whereas participants with lower self-control perceived likelihood of developing the disease significantly higher when attributed to lifestyle choices than when attributed to genetic factors. In contrast, a regression analysis on blame for developing diseases revealed that blame did not significantly differ between the two attribution conditions among participants with lower self-control, whereas blame was significantly higher when attributed to lifestyle choices than when attributed to genetic factors among participants with higher self-control in both studies. The results also show that participants with lower self-control have a tendency to allocate fewer resources toward activities demanding higher patient involvement (gym membership and nutrition specialist consultation) when the disease was attributed to lifestyle choices than when it was attributed to genetic factors, whereas participants with higher self-control had a tendency to allocate more resources toward such activities when disease was attributed to lifestyle choices than when attributed to genetic factors. Key Contributions Knowledge of the relationship between genes and human diseases has been accumulating in the area of medicine. However, understanding how such information affects consumers' medical decision making is limited. This research is an initial attempt to demonstrate the relationship between attribution of diseases and perception of the diseases based on a personal trait, self-control. Specifically, the research demonstrates that lower self-control consumers, despite believing that they have higher probability of developing a disease based on lifestyle factors, are less likely to engage in active treatments that would mitigate this higher disease risk. The opposite was the case for consumers with higher self-control. Therefore, medical practitioners and health communicators should consider individual differences in self-control trait. Future research should also test different approaches to encourage at-risk consumers to participate in active treatment programs. [ABSTRACT FROM AUTHOR]