A FUZZY-TRACE THEORY INTERVENTION TO REDUCE DISTRESS FROM POSITIVE MAMMOGRAPHY SCREENING RESULTS

Purpose: To test the efficacy of a decision aid helping women extract meaning from mammography screening results.  Undue levels of fear and anxiety in women have been considered a major harm in women age 40 to 49.  We tested the hypothesis that providing subjects with gist-centered information, based on fuzzy-trace theory, to disentangle classes of true and false positives improves understanding of test results and thus reduces anxiety.

Method: Participants (N = 395; mean age = 19.85, SD = 1.89; 75% female; 51.5% White, 8.2% African American, 26.6% Asian, 6.9% other ethnicity; 11.9% Hispanic) were asked to imagine they were a 45-year-old woman receiving the results of a mammography screening.  They were told that they either had a positive or a negative test result.  They were subsequently presented with an informational aid either based on fuzzy-trace theory or standard information available on the National Cancer Institute’s webpage.  The theoretical intervention was based on fuzzy-trace theory’s prediction that poor understanding of risks from mammography screening is not due to a lack of conceptual understanding of probability, but to interference among overlapping classes.  Based on this prediction, this intervention used a visual aid that helps disentangle numerators in comparison to their denominators in probability estimates (e.g., number of people with vs. without breast cancer who received a positive result).  Finally, they were told that follow-up testing revealed their results to be either positive or negative.  Anxiety was assessed at three times (after mammography screening result, after intervention, and after actual result) using the 8-item Champion et al. (2004) 5-point Likert scale ( α = .95; e.g., “Right now, the thought of breast cancer scares me”).

Result: Participants imagined that they received a positive mammography screening results showed more anxiety than those who received a negative result.  However, the theory-based intervention significantly reduced anxiety for participants who received a positive result, even after controlling for gender, race/ ethnicity, family history of breast cancer, and numeracy.

Conclusion: The fuzzy-trace theory intervention was successful in reducing anxiety from positive screening mammography results by simplifying information processing and reducing interference from overlapping classes through the development of an effective educational tool that aids healthy decision-making.