Behaviourally designed treatments that increase willingness to treatment from families with children suffering from autism spectrum disorder

J Epidemiol Community Health. 2015 Oct;69(10):958-62. doi: 10.1136/jech-2015-205505. Epub 2015 Apr 22.

Abstract

Background: Autism spectrum disorder is a lifelong disability that is not well known by the general population and tends to be associated with social stigma; also, because it involves children, it may get highly emotionally charged. These stylised facts engender a number of possible heuristics and biases at the moment of deciding on following a treatment or looking for a diagnosis, which should be considered in the presentation of information. Using insights from Behavioural Economics, three treatments are designed to present the information regarding possible therapies.

Methods: Between-subjects design with one level of variation. Interviews were performed with a convenience sample of 154 households from the metropolitan area of Bogotá (Colombia). The treatments include: use of default option, use of professional interviewer to illustrate the therapy and emotionally charged presentation.

Results: Kruskal-Wallis test of the intention to be treated rejects the null hypothesis (χ(2)=22.14, p=0.00). The cognitive processing of the information is not a determinant, supporting the claim that genuine framing effects shape the choice. The strongest effect of the treatment with a professional suggests a key role for asymmetry of the information, which is confirmed indirectly through the postexperiment questionnaire.

Conclusions: Bad healthcare decisions are not necessarily driven by lack of information. Asymmetric information (eg, delegating the decision to a professional) improves choices, especially when social stigma is involved. Cognitive processing of information seems to be less relevant than the framing effect.

Keywords: ACCESS TO HLTH CARE; COGNITION; Decision Analysis.

MeSH terms

  • Adult
  • Analysis of Variance
  • Autism Spectrum Disorder / psychology*
  • Autism Spectrum Disorder / therapy
  • Behavior Therapy / methods*
  • Child
  • Colombia
  • Family / psychology*
  • Humans
  • Male
  • Parental Consent / psychology*
  • Patient Acceptance of Health Care / psychology*
  • Professional-Family Relations
  • Social Stigma
  • Statistics, Nonparametric