School of Communication, Ohio State University, Columbus, Ohio, USA.
J Health Commun. 2011 Jan;16(1):3-16. doi: 10.1080/10810730.2010.529494.
Patients often have difficulty understanding what randomization is and why it is needed in Phase III clinical trials. Physicians commonly report using metaphorical language to convey the role of chance in being assignment to treatment; however, the effectiveness of this strategy as an educational tool has not been explored. Guided by W. McGuire's (1972) information-processing model, the purpose of this pilot study was to explore effects of metaphors to explain randomization on message acceptance and behavioral intention to participate in a Phase III clinical trial among a sample of low-income, rural women (N = 64). Participants were randomly assigned to watch a video that explained randomization using 1 of 3 message strategies: a low-literacy definition, standard metaphor (i.e., flip of a coin), or a culturally derived metaphor (i.e., sex of a baby). The influence of attention on behavioral intentions to participate in clinical trials was partially moderated by message strategy. Under conditions of low attention, participants in the culturally derived metaphor condition experienced significantly higher intentions to participate in clinical trials compared with participants in the standard metaphor condition. However, as attention increased, differences in intentions among the conditions diminished. Having a positive affective response to the randomization message was a strong, positive predictor of behavioral intentions to participate in clinical trials. The authors discuss the theoretical and practical implications of these findings.
患者通常难以理解什么是随机化以及为什么在 III 期临床试验中需要随机化。医生通常会使用隐喻语言来描述机会在分配治疗中的作用；然而，这种策略作为一种教育工具的有效性尚未得到探索。本研究以 W. McGuire（1972）的信息处理模型为指导，旨在探讨解释随机化的隐喻对低收入、农村妇女样本（N=64）接受信息和参与 III 期临床试验的行为意向的影响。参与者被随机分配观看一段视频，该视频使用 3 种信息策略中的 1 种解释随机化：低识字定义、标准隐喻（即抛硬币）或文化衍生隐喻（即婴儿性别）。注意力对临床试验参与行为意向的影响部分受到信息策略的调节。在注意力较低的情况下，与标准隐喻条件相比，文化衍生隐喻条件下的参与者参与临床试验的意愿显著更高。然而，随着注意力的增加，各条件之间的意愿差异逐渐减小。对随机化信息有积极的情感反应是参与临床试验的强烈积极预测因素。作者讨论了这些发现的理论和实践意义。
