title: An exploration of decision aid effectiveness: the impact of promoting affective vs. deliberative processing on a health-related decision.
abstract: BACKGROUND
  Decision aids (DAs) are non-directive communication tools that help patients make value-consistent health-care decisions. However, most DAs have been developed without an explicit theoretical framework, resulting in a lack of understanding of how DAs achieve outcomes.
  
  
  OBJECTIVE
  To investigate the effect of promoting affective vs. deliberative processing on DA effectiveness based on dual-process theory.
  
  
  METHODS
  One hundred and forty-eight female university students participated in a randomized controlled experiment with three conditions: emotion-focused, information-focused and control. Preference-value consistency, knowledge, decisional conflict and satisfaction were compared across the conditions using planned contrast analyses.
  
  
  METHODS
  The intervention comprised two different DAs and instructional manipulations. The emotion-focused condition received a modified DA with affective content and instructions to induce an affective reaction. The information-focused and control conditions received the same DA without the affective content. The information-focused condition received additional instructions to induce deliberative processing.
  
  
  RESULTS
  Controlling for the experiment-wise error rate at P < 0.017, the emotion-focused and information-focused conditions had significantly higher decisional satisfaction than the control condition (P < 0.001). The emotion-focused condition did not demonstrate preference-value consistency. There were no significant differences for decisional conflict and knowledge.
  
  
  CONCLUSIONS
  Results suggest that the promotion of affective processing may hinder value-consistent decision making, while deliberative processing may enhance decisional satisfaction.
  
  
  CONCLUSIONS
  This investigation of the effect of affective and deliberative processes in DA-supported decision making has implications for the design and use of DAs. DA effectiveness may be enhanced by incorporating a simple instruction to focus on the details of the information.
authors.affiliation: School of Psychology, The University of Sydney, Sydney, NSW, Australia.
authors.forename: Esther L
authors.initials: EL
authors.lastname: Davis
authors.affiliation: School of Psychology, The University of Sydney, Sydney, NSW, Australia.
authors.forename: Kirsten
authors.initials: K
authors.lastname: McCaffery
authors.affiliation: School of Psychology, The University of Sydney, Sydney, NSW, Australia.
authors.forename: Barbara
authors.initials: B
authors.lastname: Mullan
authors.affiliation: School of Psychology, The University of Sydney, Sydney, NSW, Australia.
authors.forename: Ilona
authors.initials: I
authors.lastname: Juraskova
mesh_terms: D000339:Affect; D003267:Contraception / Q000523:psychology; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D011581:Psychological Tests; D011795:Surveys and Questionnaires; D013850:Thinking; D055815:Young Adult
keywords: decision aid; decision-making; dual-process theory; health psychology