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Background: Many everyday health decisions involve intertemporal choice: trade-offs between immediate pleasure or convenience and a potentially larger, delayed health benefit. Time preference, or the extent to which people discount future benefits in favor of immediate benefits, might represent an important determinant of preventive health behavior. However, research to date on the relationship between time preference and health behavior has yielded mixed results.
Purpose: To examine the association between future time preference and utilization of genetic counseling for BRCA1/2 testing, annual mammography screening, and monthly self breast examination.
Methods: Because use of BRCA1/2 counseling is rare, a prospective health system based case-control study was used to assess the association between time preference and BRCA1/2 counseling. Because women who undergo BRCA1/2 counseling are not representative of the general population of women, a nested cross-sectional analysis of controls was used to assess the associations between time preference and mammography and self breast exam. Cases (n=234) were adult women without breast or ovarian cancer who underwent BRCA1/2 counseling within the University of Pennsylvania health system. Controls (n=566) were adult women without breast or ovarian cancer who saw a primary care physician in the same health system but did not seek genetic counseling. Subjects completed a questionnaire assessing their time preference (using the Revised Consideration of Future Consequences Scale, Cronbach’s á = .71), annual mammography adherence, self breast exam frequency, family history, and sociodemographics.
Results: A stronger future time preference was seen among those with higher educational attainment (p<.0001) and income (p<.0001), and who were Caucasian (p=.025). The association between a future time preference and health behavior was strong and positive for utilization of genetic counseling (comparing cases and controls) (OR 2.6, 95% CI 1.8-3.6) and weaker but still significant for adherence to annual mammogram (OR 1.5, 95% CI 1.0-2.4), and absent for adherence to monthly self breast exam (OR 1.0, 95% CI 0.7-1.3). For all three behavioral outcomes, the odds ratios did not change when adjusting for degree of family history and sociodemographic characteristics.
Conclusions: Time preference is associated with health behavior, but the strength of the association varies with the behavior. The extent to which people value the future may be important for understanding and increasing the extent to which they perform preventive health behaviors.
See more of Oral Concurrent Session A - Patient and Physician Behavior/Preferences 2
See more of The 26th Annual Meeting of the Society for Medical Decision Making (October 17-20, 2004)