THE EFFECT OF NARRATIVE FORMAT ON INFORMATION SEARCH USING A WEB-BASED BREAST CANCER DECISION AID

Purpose: To examine the impact of narrative format (text vs. video) on information search in a web-based patient decision aid for early stage breast cancer.

Method: 56 women were asked to imagine that they had been diagnosed with early stage breast cancer and needed to choose between two surgical treatments (lumpectomy with radiation or mastectomy). Participants were provided with one of four versions of a web decision aid. In two narrative conditions, interviews of both patients and physicians were provided as either text or video. In the remaining two conditions without narratives, only physician interviews were provided as either text or video. Participants could freely browse the web decision aid until they developed a treatment preference. We recorded participants’ eye movements using the Tobii 1750 eye-tracking system equipped with Tobii Studio software. A priori, we defined 25 Areas of Interest (AOIs) on the web decision aid. These AOIs were either separate pages of the web decision aid or sections within a single page covering different content. The 25 AOIs nested within each of the 56 participants provides approximately 1,400 measurement occasions.

Result: We compared average total fixation duration in each AOI between the four conditions using a 4 x 25 mixed ANOVA. There were no main effects of narrative presence or narrative format. However, there was a significant narrative presence by narrative format interaction on mean total fixation duration, F (1, 30) = 9.74, p < .01 partial η² = .25; see Figure 1. In the text conditions, participants provided with narratives spent less time searching for information than participants in the control condition. However, in the video conditions, participants provided with narratives spent more time searching for information than the control condition. These findings indicate that narrative presence and format impact global (i.e. across the entire website) differences in search strategy; other local (i.e. page specific) search patterns may also exist.

Conclusion: The observed increase in total fixation duration with video patient testimonials is consistent with the idea that the vividness of video content could encourage greater information search. However, the reverse effect of video observed in the no narrative condition is difficult to explain. Further research on the effect of video vs. textual presentations is clearly warranted.