The role of prospect theory in screening behavior decision-making in a health-insured population of South Africa

Adonis, Leegale, Basu, Debashis and Luiz, John (2015) The role of prospect theory in screening behavior decision-making in a health-insured population of South Africa. Journal of Psychology and Psychotherapy, 5 (5). ISSN 2161-0487

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Abstract

Background: Prospect theory suggests that people avoid risks when faced with the benefits of a decision but take risks when faced with the costs of a decision. Screening for diseases can be defined as a ‘risk’, in the context of uncertainty. The outcome can either be a ‘benefit’ of good health or a ‘cost’ of ill health or poor-quality health.

Purpose: To assess whether prospect theory can predict screening behavior in the context of a chronic disease diagnosis as well as the exposure to incentives to screen.

Methods: A retrospective longitudinal case-control study for the period 2008-2011 was conducted using a random 1% sample of 170,471 health-insured members, assessing screening for cancers, chronic diseases of lifestyle and HIV, some of whom voluntarily join an incentivized wellness program.

Results: Individuals diagnosed with a chronic disease screened up to 9.0% less for some diseases over time. Mammogram screening however increased (p<0.001). Where a family member was diagnosed with a chronic disease, individual screening decreased up to 8.6%. Similarly females in families where a member was diagnosed with a chronic disease screened more for breast cancer (p<0.001). Males were more sensitive to incentives only for HIV screening (p<0.001), while the female responses to incentives were inconsistent.

Conclusion: A chronic disease diagnosis or the risk of developing a chronic disease resulted in reduced future screening behavior for most diseases. The role of incentives was inconsistent. Prospect theory adequately predicts screening behavior when diagnosed or faced with a possible chronic disease diagnosis for most screening tests except for females screening for breast cancer.

Item Type: Article
Schools and Departments: School of Business, Management and Economics > Business and Management
Depositing User: Stacey Goldup
Date Deposited: 06 Jun 2017 11:15
Last Modified: 06 Jun 2017 12:16
URI: http://sro.sussex.ac.uk/id/eprint/68366

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