WELL-DESIGNED RISK COMMUNICATION AND VALUES CLARIFICATION METHODS IMPROVE PARENTS' DECISIONS ABOUT INFLUENZA VACCINES FOR THEIR CHILDREN

Purpose: When choosing between two options, especially in cases of small probabilities and emotion-laden risks, people can make choices that fail to align with their own values. Our previous research has demonstrated, in a hypothetical decision context, that particular design features of interactive web-based interfaces can help people make choices that better align with their values. This study aimed to test such design features in a real decision context.

Method: In November and December 2013 we conducted an online factorial experiment in which participants were randomized to receive information about influenza vaccines for children presented either in the standard format of the U.S. Centers for Disease Control and Prevention or in a best practices risk communication format. The latter used techniques such as presenting absolute risks in frequency format, using risk graphics, and explicitly presenting the incremental differences between the risks associated with each option. Participants were also randomized such that half of them received an interactive values clarification interface with dynamic visual feedback showing how their values related to the decision to vaccinate or not. We assessed all participants’ intentions to have their children vaccinated against influenza and the alignment between their intentions and values. To be eligible for the study, participants had to be parents/guardians in the US whose children were eligible for influenza immunization but had not yet received a vaccine in the current season.

Results: Participants (n=407) were a diverse sample of parents/guardians (mean age 35, SD 9, 63% female, 80% white, 47% no college degree) of children aged 6 months to 17 years. Participants randomized to the best practices risk communication format combined with the values clarification interface were most likely to indicate intentions to vaccinate (beta=2.08, p<.01). This effect was particularly notable among participants who had previously demonstrated less willingness to have their children vaccinated against influenza (beta=-2.14, p<.05). In addition, regardless of their intentions, participants receiving both interventions were the most likely to make choices that aligned with their values (Chi-squared(15)=32.1, p<0.01).

Conclusion: Good design for both risk communication and values clarification can improve decision quality by helping people to better understand the risks and benefits of options and to see how their values connect to their decisions.