Transparent Communication of Health Risks by Rocio Garcia-Retamero & Mirta Galesic

Author:Rocio Garcia-Retamero & Mirta Galesic
Language: eng
Format: epub
Publisher: Springer New York, New York, NY

8.3 Discussion and Conclusions

We found much better recall for consequences of health-related behaviors when they were expressed as changes in life expectancy rather than in terms of risk of getting a disease. The improvements in the recall persisted as long as 3 weeks. At the same time, the life expectancy format did not bias perceptions of risk. Rated importance of maintaining healthy weight and exercising was the same for both presentation formats. This result is promising for public health campaigns aimed at improving people’s awareness about unhealthy consequences of risky lifestyles such as smoking, obesity, and physical inactivity.

These effects seem to be mediated by a primarily cognitive mechanism that acts through enhanced imaginability of the information, enabling better encoding and a richer memory trace. The other, primarily emotional mechanism acting through lower desirability of risk of disease might have played a role, but any effect of that factor was probably overpowered by the effect of imaginability. These results are in line with the dual-coding theory of Paivio (1969, 1971, 1986), who proposed that words higher in imaginability enable both verbal and visual encoding, thus enhancing subsequent recall. Studies on implementation of intentions (Chasteen et al. 2001; Gollwitzer 1999; Liu and Park 2004) in which patients who imagine a task (e.g., taking their prescription medication) are subsequently more likely to remember to do the task are also in accord with our findings. Our results are consistent with previous findings that low-numeracy people have problems understanding statistical information about risks (Estrada et al. 2004; Galesic et al. 2009; Garcia-Retamero and Galesic 2009; Nelson et al. 2008; Peters et al. 2006; Schwartz et al. 1997; Woloshin et al. 2001). However, their performance was improved to the level of high-numeracy people when the consequences of risky behaviors were presented in terms of life expectancy, in both the USA and Germany. As low-numeracy people are often of lower socioeconomic status (see Table 8.1), and correspondingly more likely to lack health insurance (see Chap. 2; see also Galesic and Garcia-Retamero 2010) and have unhealthy lifestyles (Schoen et al. 2005), simple framing manipulations such as these are an important tool for improving this population’s informed decision making about health.

This chapter makes several contributions to the existing literature on risk communication. First, to the best of our knowledge, no study so far has compared recall of health-related information expressed in terms of life expectancy versus risk reduction, although this is a very important aspect for developers and distributors of health information. If one of these formats produces superior recall without biasing risk perception, then this format should be preferred when planning public health campaigns. Second, we suggest and test two theoretical rationales about the mechanisms underlying improvements in recall, one primarily cognitive (imaginability) and the other primarily emotional (undesirability). Third, by using probabilistic national samples of low- and high-numeracy people in two countries, we test the generalizability of our findings to different patient groups.

Our findings have significant implications for medical practice. When it is desired that patients memorize

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