BACKGROUND: Health-related information found on the Internet is increasing and impacts patient decision making, e.g. regarding vaccination decisions. In addition to statistical information (e.g. incidence rates of vaccine adverse events), narrative information is also widely available such as postings on online bulletin boards. Previous research has shown that narrative information can impact treatment decisions, even when statistical information is presented concurrently.
OBJECTIVES: As the determinants of this effect are largely unknown, we will vary features of the narratives to identify mechanisms through which narratives impact risk judgments.
METHODS: An online bulletin board setting provided participants with statistical information and authentic narratives about the occurrence and nonoccurrence of adverse events. Experiment 1 followed a single factorial design with 1, 2, or 4 narratives out of 10 reporting adverse events. Experiment 2 implemented a 2 (statistical risk 20% vs. 40%) × 2 (2/10 vs. 4/10 narratives reporting adverse events) × 2 (high vs. low richness) × 2 (high vs. low emotionality) between-subjects design. Dependent variables were perceived risk of side-effects and vaccination intentions.
RESULTS: Experiment 1 shows an inverse relation between the number of narratives reporting adverse-events and vaccination intentions, which was mediated by the perceived risk of vaccinating. Experiment 2 showed a stronger influence of the number of narratives than of the statistical risk information. High (vs. low) emotional narratives had a greater impact on the perceived risk, while richness had no effect.
IMPLICATIONS: The number of narratives influences risk judgments can potentially override statistical information about risk.