反疫苗叙事与亲疫苗叙事对不同计算能力的接受者反应的影响：一项基于横断面调查的实验。
Effects of Anti- Versus Pro-Vaccine Narratives on Responses by Recipients Varying in Numeracy: A Cross-sectional Survey-Based Experiment.
机构信息
Centre for Decision Research, Leeds University Business School, Leeds, UK (WB).
Department of Engineering and Public Policy, Carnegie Mellon University (WB).
出版信息
Med Decis Making. 2017 Nov;37(8):860-870. doi: 10.1177/0272989X17704858. Epub 2017 May 5.
BACKGROUND
To inform their health decisions, patients may seek narratives describing other patients' evaluations of their treatment experiences. Narratives can provide anti-treatment or pro-treatment evaluative meaning that low-numerate patients may especially struggle to derive from statistical information. Here, we examined whether anti-vaccine (v. pro-vaccine) narratives had relatively stronger effects on the perceived informativeness and judged vaccination probabilities reported among recipients with lower (v. higher) numeracy.
METHODS
Participants ( n = 1,113) from a nationally representative US internet panel were randomly assigned to an anti-vaccine or pro-vaccine narrative, as presented by a patient discussing a personal experience, a physician discussing a patient's experience, or a physician discussing the experiences of 50 patients. Anti-vaccine narratives described flu experiences of patients who got the flu after getting vaccinated; pro-vaccine narratives described flu experiences of patients who got the flu after not getting vaccinated. Participants indicated their probability of getting vaccinated and rated the informativeness of the narratives.
RESULTS
Participants with lower numeracy generally perceived narratives as more informative. By comparison, participants with higher numeracy rated especially anti-vaccine narratives as less informative. Anti-vaccine narratives reduced the judged vaccination probabilities as compared with pro-vaccine narratives, especially among participants with lower numeracy. Mediation analyses suggested that low-numerate individuals' vaccination probabilities were reduced by anti-vaccine narratives-and, to a lesser extent, boosted by pro-vaccine narratives-because they perceived narratives to be more informative. These findings were similar for narratives provided by patients and physicians.
CONCLUSIONS
Patients with lower numeracy may rely more on narrative information when making their decisions. These findings have implications for the development of health communications and decision aids.
背景
为了做出自己的健康决策，患者可能会寻求描述其他患者对治疗体验的评价的叙述。叙述可以提供反治疗或亲治疗的评价意义，而低数字素养的患者可能尤其难以从统计信息中得出这些意义。在这里，我们研究了反疫苗（亲疫苗）叙述对数字素养较低（高）的接受者报告的感知信息性和判断疫苗接种概率的影响是否更强。
方法
来自美国全国代表性互联网小组的参与者（n=1113）被随机分配到反疫苗或亲疫苗的叙述中，叙述由一名患者讨论个人经历、一名医生讨论患者的经历或一名医生讨论 50 名患者的经历。反疫苗叙述描述了接种疫苗后仍患流感的患者的流感经历；亲疫苗叙述描述了未接种疫苗后仍患流感的患者的流感经历。参与者表示他们接种疫苗的概率，并对叙述的信息性进行评分。
结果
数字素养较低的参与者通常认为叙述更具信息量。相比之下，数字素养较高的参与者特别认为反疫苗叙述的信息量较少。与亲疫苗叙述相比，反疫苗叙述降低了判断的疫苗接种概率，尤其是在数字素养较低的参与者中。中介分析表明，反疫苗叙述降低了低数字素养个体的疫苗接种概率-而且，在较小程度上，亲疫苗叙述也提高了他们的疫苗接种概率-因为他们认为叙述更具信息量。这些发现与患者和医生提供的叙述相似。
结论
数字素养较低的患者在做出决策时可能更依赖叙述信息。这些发现对健康传播和决策辅助工具的开发具有启示意义。
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