Division of Infectious Disease/Program in Global Health, epartment of Medicine, University of California, Los Angeles, CA 90095, USA.
Health Psychol. 2009 Nov;28(6):675-81. doi: 10.1037/a0016395.
Little research has studied experimentally whether an opt-out policy will increase testing rates or whether this strategy is especially effective in the case of stigmatized diseases such as HIV.
In Study 1, a 2 x 2 factorial design asked participants to make moral judgments about a person's decision to test for stigmatized diseases under an opt-in versus an opt-out policy. In Study 2, a 2 x 2 factorial design measuring testing rates explored whether opt-out methods reduce stigma and increase testing for stigmatized diseases.
Study 1 results suggest that getting tested draws suspicion regarding moral conduct in an opt-in system, whereas not getting tested draws suspicion in an opt-out system. Study 2 results suggest that an opt-out policy may increase testing rates for stigmatized diseases and lessen the effects of stigma in people's reluctance to test.
A social psychological approach to health services can be used to show how testing policies can influence both the stigmatization associated with testing and participation rates. An understanding of how testing policies may affect patient decision making and behavior is imperative for creating effective testing policies.
几乎没有研究从实验角度探讨过“选择退出”政策是否会提高检测率，也没有研究过这种策略对于艾滋病毒等受污名化疾病是否特别有效。
在研究 1 中，采用 2 x 2 析因设计要求参与者在“选择加入”与“选择退出”政策下，对一个人决定检测受污名化疾病做出道德判断。在研究 2 中，采用 2 x 2 析因设计衡量检测率，以探索“选择退出”方法是否可以减少污名化并增加对受污名化疾病的检测。
研究 1 的结果表明，在“选择加入”系统中，接受检测会引起对道德行为的怀疑，而在“选择退出”系统中，不接受检测会引起怀疑。研究 2 的结果表明，“选择退出”政策可能会提高受污名化疾病的检测率，并减轻人们不愿检测时的污名化影响。
可以采用社会心理学方法来探讨卫生服务政策如何影响与检测相关的污名化和参与率。了解检测政策如何影响患者的决策和行为对于制定有效的检测政策至关重要。
