Paper in Health Expectations
  • Davis, E.L., McCaffery, K., Mullan, B., Juraskova, I. (2015). An exploration of decision aid effectiveness: the impact of promoting affective vs. deliberative processing on a health-related decision. Health Expectations, 18:2742-2752.
    ABSTRACT

    Background:  
    Decision aids (DAs) are non-directive communication tools that help patients make value-consistent health-care decisions. However, most DAs have been developed without an explicit theoretical framework, resulting in a lack of understanding of how DAs achieve outcomes.

    Objective:
    To investigate the effect of promoting affective vs. deliberative processing on DA effectiveness based on dual-process theory.

    Design, setting and participants:
    One hundred and forty-eight female university students participated in a randomized controlled experiment with three conditions: emotion-focused, information-focused and control. Preference-value consistency, knowledge, decisional conflict and satisfaction were compared across the conditions using planned contrast analyses.

    Intervention:
    The intervention comprised two different DAs and instructional manipulations. The emotion-focused condition received a modified DA with affective content and instructions to induce an affective reaction. The information-focused and control conditions received the same DA without the affective content. The information-focused condition received additional instructions to induce deliberative processing.

    Results:
    Controlling for the experiment-wise error rate at P < 0.017, the emotion-focused and information-focused conditions had significantly higher decisional satisfaction than the control condition (P < 0.001). The emotion-focused condition did not demonstrate preference-value consistency. There were no significant differences for decisional conflict and knowledge.

    Discussion:
    Results suggest that the promotion of affective processing may hinder value-consistent decision making, while deliberative processing may enhance decisional satisfaction.

    Conclusions:
    This investigation of the effect of affective and deliberative processes in DA-supported decision making has implications for the design and use of DAs. DA effectiveness may be enhanced by incorporating a simple instruction to focus on the details of the information.