How health labels affect behavioural intentions and perceptions of illnesses.

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How clinicians describe a health problem influences the health decisions of patients. A recent systematic review (Nickel, et al., 2017) identified seven studies that provided participants with hypothetical scenarios that described health conditions. Each condition was described using two or more differing terminologies (medicalised or descriptive). For example, when a participant read a hypothetical scenario about polycystic ovary syndrome (PCOS), when the participant was given the name of the health condition (PCOS) compared with the description of a ‘hormonal imbalance’, they were more likely to have an ultrasound (Copp et al., 2017), or when told in the scenario their child had Gastro-oesophageal reflux compared with only a description of symptoms, participants had greater intention to treat the condition with medication (Scherer et al., 2013). These studies share several characteristics: subjects were young women, scenarios were hypothetical, and both investigated a single illness potentially prone to overdiagnosis. But they can only speculate on possible cognitive processes driving subjects’ decisions because they lack mechanisms to formally test possible psychological factors driving the changes in intentions. Using four hypothetical health conditions (each with a diagnostic labelled version and a description only version) we will analyse between group differences of participants intentions to undertake further tests. We will also report differences in satisfaction and confidence in decision making and explore the effects of participant characteristics (personality, health locus of control, regulatory focus, medical minimiser/maximiser), risk orientation, risk perceptions and stigma on intention to undertake further tests. Drawing from the extensive body of research on ‘perceptions of risk’ (Slovic 2000) and stigma (Brakel 2006), we will also explore differences in perceptions of risk between labelled and description only scenarios for each of four illnesses. Finally, we will conduct exploratory analysis of whether intentions to pursue follow on tests (as well as satisfaction and confidence in decision) differ by illness condition as well as by label versus description only. References: Nickel B, Barratt A, Copp T, Mynihan R, McCaffery K. Words do matter: a systematic review on how different terminologies for the same condition influences management preferences. BMJ Open 2017 Copp T, McCaffery K, Azizi L, Doust J, Mol BWJ, Jansen J. Influence of the disease label ‘polycystic ovary syndrome’ on intention to have an ultrasound and psychosocial outcomes: a randomised online study in young women. Human Reproduction 2017 Scherer LD, Zikmund-Fisher BJ, Fagerlin A, Tarini BA. Influence of “GERD” label on parents’ decision to medicate infants. Pediatrics 2013 Slovic P. (2000) The Perception of Risk. Brakel WH. Measuring health-related stigma – A review of the literature.