IDEAS home Printed from https://ideas.repec.org/a/kap/jrisku/v62y2021i1d10.1007_s11166-021-09344-x.html
   My bibliography  Save this article

The modest effects of fact boxes on cancer screening

Author

Listed:
  • Michael R. Eber

    (Harvard University
    Harvard T.H. Chan School of Public Health)

  • Cass R. Sunstein

    (Harvard University, Robert Walmsley University Professor)

  • James K. Hammitt

    (Harvard University
    Université Toulouse Capitole
    Harvard T.H. Chan School of Public Health)

  • Jennifer M. Yeh

    (Harvard Medical School
    Boston Children’s Hospital)

Abstract

As health care becomes increasingly personalized to the needs and values of individual patients, informational interventions that aim to inform and debias consumer decision-making are likely to become important tools. In a randomized controlled experiment, we explore the effects of providing participants with published fact boxes on the benefits and harms of common cancer screening procedures. Female participants were surveyed about breast cancer screening by mammography, while male participants were surveyed about prostate cancer screening by prostate-specific antigen (PSA) testing. For these screening procedures, we expect consumers to have overly optimistic prior beliefs about the benefits and harms. We find that participants update their beliefs about the net benefits of screening modestly, but we observe little change in their stated preferences to seek screening. Participants who scored higher on a numeracy test updated their beliefs about screening benefits more in response to the fact boxes than did participants who scored lower on the numeracy test.

Suggested Citation

  • Michael R. Eber & Cass R. Sunstein & James K. Hammitt & Jennifer M. Yeh, 2021. "The modest effects of fact boxes on cancer screening," Journal of Risk and Uncertainty, Springer, vol. 62(1), pages 29-54, February.
  • Handle: RePEc:kap:jrisku:v:62:y:2021:i:1:d:10.1007_s11166-021-09344-x
    DOI: 10.1007/s11166-021-09344-x
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s11166-021-09344-x
    File Function: Abstract
    Download Restriction: Access to full text is restricted to subscribers.

    File URL: https://libkey.io/10.1007/s11166-021-09344-x?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. repec:mpr:mprres:7375 is not listed on IDEAS
    2. Basu, Anirban & Jena, Anupam B. & Philipson, Tomas J., 2011. "The impact of comparative effectiveness research on health and health care spending," Journal of Health Economics, Elsevier, vol. 30(4), pages 695-706, July.
    3. Zarek C. Brot-Goldberg & Amitabh Chandra & Benjamin R. Handel & Jonathan T. Kolstad, 2017. "What does a Deductible Do? The Impact of Cost-Sharing on Health Care Prices, Quantities, and Spending Dynamics," The Quarterly Journal of Economics, Oxford University Press, vol. 132(3), pages 1261-1318.
    4. Jeffrey R. Kling & Sendhil Mullainathan & Eldar Shafir & Lee C. Vermeulen & Marian V. Wrobel, 2012. "Comparison Friction: Experimental Evidence from Medicare Drug Plans," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(1), pages 199-235.
    5. Christoph M. Rheinberger & James K. Hammitt, 2018. "Dinner with Bayes: On the revision of risk beliefs," Journal of Risk and Uncertainty, Springer, vol. 57(3), pages 253-280, December.
    6. Angela Fagerlin & Brian J. Zikmund-Fisher & Peter A. Ubel & Aleksandra Jankovic & Holly A. Derry & Dylan M. Smith, 2007. "Measuring Numeracy without a Math Test: Development of the Subjective Numeracy Scale," Medical Decision Making, , vol. 27(5), pages 672-680, September.
    7. Adler, Matthew D. & Dolan, Paul & Kavetsos, Georgios, 2017. "Would you choose to be happy? Tradeoffs between happiness and the other dimensions of life in a large population survey," Journal of Economic Behavior & Organization, Elsevier, vol. 139(C), pages 60-73.
    8. Pedro Bordalo & Nicola Gennaioli & Andrei Shleifer, 2020. "Memory, Attention, and Choice," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 135(3), pages 1399-1442.
    9. Viscusi, W Kip, 1989. "Prospective Reference Theory: Toward an Explanation of the Paradoxes," Journal of Risk and Uncertainty, Springer, vol. 2(3), pages 235-263, September.
    10. Isaac M. Lipkus & Ellen Peters & Gretchen Kimmick & Vlayka Liotcheva & Paul Marcom, 2010. "Breast Cancer Patients’ Treatment Expectations after Exposure to the Decision Aid Program Adjuvant Online: The Influence of Numeracy," Medical Decision Making, , vol. 30(4), pages 464-473, July.
    11. Hertwig, Ralph, 2017. "When to consider boosting: some rules for policy-makers," Behavioural Public Policy, Cambridge University Press, vol. 1(2), pages 143-161, November.
    12. Benjamin R. Handel & Jonathan T. Kolstad, 2015. "Health Insurance for "Humans": Information Frictions, Plan Choice, and Consumer Welfare," American Economic Review, American Economic Association, vol. 105(8), pages 2449-2500, August.
    13. Hammitt, James K & Graham, John D, 1999. "Willingness to Pay for Health Protection: Inadequate Sensitivity to Probability?," Journal of Risk and Uncertainty, Springer, vol. 18(1), pages 33-62, April.
    14. Smith, V Kerry & Johnson, F Reed, 1988. "How Do Risk Perceptions Respond to Information? The Case of Radon," The Review of Economics and Statistics, MIT Press, vol. 70(1), pages 1-8, February.
    15. Cass R. Sunstein, 2019. "Ruining popcorn? The welfare effects of information," Journal of Risk and Uncertainty, Springer, vol. 58(2), pages 121-142, June.
    16. Daniel Zizzo, 2010. "Experimenter demand effects in economic experiments," Experimental Economics, Springer;Economic Science Association, vol. 13(1), pages 75-98, March.
    17. Isaac M. Lipkus & Greg Samsa & Barbara K. Rimer, 2001. "General Performance on a Numeracy Scale among Highly Educated Samples," Medical Decision Making, , vol. 21(1), pages 37-44, February.
    18. Eric J Johnson & Ran Hassin & Tom Baker & Allison T Bajger & Galen Treuer, 2013. "Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-6, December.
    19. Eric Johnson & Suzanne Shu & Benedict Dellaert & Craig Fox & Daniel Goldstein & Gerald Häubl & Richard Larrick & John Payne & Ellen Peters & David Schkade & Brian Wansink & Elke Weber, 2012. "Beyond nudges: Tools of a choice architecture," Marketing Letters, Springer, vol. 23(2), pages 487-504, June.
    20. Peter J. Neumann & Joshua T. Cohen & James K. Hammitt & Thomas W. Concannon & Hannah R. Auerbach & ChiHui Fang & David M. Kent, 2012. "Willingness‐to‐pay for predictive tests with no immediate treatment implications: a survey of US residents," Health Economics, John Wiley & Sons, Ltd., vol. 21(3), pages 238-251, March.
    21. Michelle McDowell & Gerd Gigerenzer & Odette Wegwarth & Felix G. Rebitschek, 2019. "Effect of Tabular and Icon Fact Box Formats on Comprehension of Benefits and Harms of Prostate Cancer Screening: A Randomized Trial," Medical Decision Making, , vol. 39(1), pages 41-56, January.
    22. Bernheim, B. Douglas, 2016. "The Good, the Bad, and the Ugly: A Unified Approach to Behavioral Welfare Economics1," Journal of Benefit-Cost Analysis, Cambridge University Press, vol. 7(1), pages 12-68, April.
    23. Russell Golman & David Hagmann & George Loewenstein, 2017. "Information Avoidance," Journal of Economic Literature, American Economic Association, vol. 55(1), pages 96-135, March.
    24. Sunstein,Cass R., 2016. "The Ethics of Influence," Cambridge Books, Cambridge University Press, number 9781107140707.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Andrew J Barnes & Yaniv Hanoch & Thomas Rice, 2016. "Can Plan Recommendations Improve the Coverage Decisions of Vulnerable Populations in Health Insurance Marketplaces?," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-19, March.
    2. repec:cup:judgdm:v:9:y:2014:i:2:p:152-158 is not listed on IDEAS
    3. Dickie, Mark & Adamowicz, Wiktor & Gerking, Shelby & Veronesi, Marcella, 2022. "Risk Perception, Learning, and Willingness to Pay to Reduce Heart Disease Risk," Journal of Benefit-Cost Analysis, Cambridge University Press, vol. 13(3), pages 363-382, October.
    4. Henrik Andersson & Nicolas Treich, 2011. "The Value of a Statistical Life," Chapters, in: André de Palma & Robin Lindsey & Emile Quinet & Roger Vickerman (ed.), A Handbook of Transport Economics, chapter 17, Edward Elgar Publishing.
    5. Talya Miron-Shatz & Yaniv Hanoch & Benjamin A. Katz & Glen M. Doniger & Elissa M. Ozanne, 2015. "Willingness to test for BRCA1/2 in high risk women: Influenced by risk perception and family experience, rather than by objective or subjective numeracy?," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 10(4), pages 386-399, July.
    6. Martin Gaynor & Kate Ho & Robert J. Town, 2015. "The Industrial Organization of Health-Care Markets," Journal of Economic Literature, American Economic Association, vol. 53(2), pages 235-284, June.
    7. Matija Franklin & Tomas Folke & Kai Ruggeri, 2019. "Optimising nudges and boosts for financial decisions under uncertainty," Palgrave Communications, Palgrave Macmillan, vol. 5(1), pages 1-13, December.
    8. Keith Marzilli Ericson & Justin Sydnor, 2017. "The Questionable Value of Having a Choice of Levels of Health Insurance Coverage," Journal of Economic Perspectives, American Economic Association, vol. 31(4), pages 51-72, Fall.
    9. Sai Krishnan S. & Subramanian S. Iyer & Sai Balaji SMR, 2022. "Insights from behavioral economics for policymakers of choice‐based health insurance markets: A scoping review," Risk Management and Insurance Review, American Risk and Insurance Association, vol. 25(2), pages 115-143, June.
    10. repec:cup:judgdm:v:10:y:2015:i:4:p:386-399 is not listed on IDEAS
    11. Linda Thunström, 2019. "Welfare effects of nudges: The emotional tax of calorie menu labeling," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 14(1), pages 11-25, January.
    12. Kaufmann, Cornel & Müller, Tobias & Hefti, Andreas & Boes, Stefan, 2018. "Does personalized information improve health plan choices when individuals are distracted?," Journal of Economic Behavior & Organization, Elsevier, vol. 149(C), pages 197-214.
    13. Sendhil Mullainathan & Ziad Obermeyer, 2019. "Diagnosing Physician Error: A Machine Learning Approach to Low-Value Health Care," NBER Working Papers 26168, National Bureau of Economic Research, Inc.
    14. Barnes, Andrew J. & Karpman, Michael & Long, Sharon K. & Hanoch, Yaniv & Rice, Thomas, 2021. "More intelligent designs: Comparing the effectiveness of choice architectures in US health insurance marketplaces," Organizational Behavior and Human Decision Processes, Elsevier, vol. 163(C), pages 142-164.
    15. Sunstein, Cass R., 2021. "Viewpoint: Are food labels good?," Food Policy, Elsevier, vol. 99(C).
    16. Henrik Andersson, 2011. "Perception of Own Death Risk: An Assessment of Road‐Traffic Mortality Risk," Risk Analysis, John Wiley & Sons, vol. 31(7), pages 1069-1082, July.
    17. Andersson, Henrik & Lundborg, Petter, 2006. "Perception of Own Death Risk: An Analysis of Road-Traffic and Overall Mortality Risks," Working Papers 2006:1, Swedish National Road & Transport Research Institute (VTI).
    18. Talya Miron-Shatz & Yaniv Hanoch & Glen M. Doniger & Zehra B. Omer & Elissa M. Ozanne, 2014. "Subjective but not objective numeracy influences willingness to pay for BRCA1/2 genetic testing," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 9(2), pages 152-158, March.
    19. Nathan Kettlewell, 2020. "Policy Choice and Product Bundling in a Complicated Health Insurance Market: Do People Get It Right?," Journal of Human Resources, University of Wisconsin Press, vol. 55(2), pages 566-610.
    20. Chenyuan Liu & Justin R. Sydnor, 2018. "Dominated Options in Health-Insurance Plans," NBER Working Papers 24392, National Bureau of Economic Research, Inc.
    21. repec:cup:judgdm:v:14:y:2019:i:1:p:11-25 is not listed on IDEAS
    22. Carissa Bonner & Lyndal J. Trevena & Wolfgang Gaissmaier & Paul K. J. Han & Yasmina Okan & Elissa Ozanne & Ellen Peters & Daniëlle Timmermans & Brian J. Zikmund-Fisher, 2021. "Current Best Practice for Presenting Probabilities in Patient Decision Aids: Fundamental Principles," Medical Decision Making, , vol. 41(7), pages 821-833, October.
    23. Anell, Anders & Dietrichson, Jens & Ellegård, Lina Maria & Kjellsson, Gustav, 2022. "Well-Informed Choices? Effects of Information Interventions in Primary Care on Care Quality," Working Papers 2022:2, Lund University, Department of Economics.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:kap:jrisku:v:62:y:2021:i:1:d:10.1007_s11166-021-09344-x. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.