Evaluating the Cognitive and Emotional Impact of a Risk Calculator and Support Package for People with Type 2 Diabetes.
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Abstract
Background:
Research on cardiovascular risk calculators suggests that, despite their widespread use, they have little impact on understanding of risk, motivation, or health behaviours. Possible reasons for this finding include a simple lack of understanding on the part of users, or psychological defensive mechanisms protecting the user from challenging information. We therefore undertook a qualitative study exploring users’ cognitive and emotional reactions to a newly developed cardiovascular risk calculator for people with type-2 diabetes.
Objective:
To determine the cognitive and emotional reactions to a cardiovascular risk calculator and support package developed for people with type 2 diabetes.
Methods:
The risk calculator was evaluated against a checklist of best practice in conveying risk following a review of the literature. Two focus groups (16 participants with type-2 diabetes) were conducted to gauge acceptability of the content and presentation. One-to-one interviews (data collection ongoing) were conducted to explore users’ cognitive and emotional reactions as they were using the risk calculator and immediately afterwards. All participants were adults with type 2 diabetes. Purposive sampling was used to recruit a varied sample in terms of gender, age, ethnicity, length of time since diagnosis, and internet use.
Results:
Evaluating the risk calculator against the best-practice checklist and focus group feedback identified several areas for improvement including better explanation of medical terms, displaying normal values, and altering the user journey. Cognitive and emotional reactions to the risk calculator included scepticism about its validity, demotivation, and relief.
Conclusions:
Adhering to best practices in risk communication and ensuring that users understand their individual risk are essential features of a risk calculator. However, conveying individual risk does not necessarily motivate or translate into behaviour change. This study has demonstrated the range of responses that people with type 2 diabetes have to cardiovascular risk calculators. These help to explain why risk calculators have not been shown to lead to behaviour change. Understanding how people respond when they use risk calculators can guide the development of next-generation risk calculators. One area for further research is to find ways to explain risk that bypass psychological defence mechanisms thus allowing risk information to be taken on-board without provoking undue anxiety.
Research on cardiovascular risk calculators suggests that, despite their widespread use, they have little impact on understanding of risk, motivation, or health behaviours. Possible reasons for this finding include a simple lack of understanding on the part of users, or psychological defensive mechanisms protecting the user from challenging information. We therefore undertook a qualitative study exploring users’ cognitive and emotional reactions to a newly developed cardiovascular risk calculator for people with type-2 diabetes.
Objective:
To determine the cognitive and emotional reactions to a cardiovascular risk calculator and support package developed for people with type 2 diabetes.
Methods:
The risk calculator was evaluated against a checklist of best practice in conveying risk following a review of the literature. Two focus groups (16 participants with type-2 diabetes) were conducted to gauge acceptability of the content and presentation. One-to-one interviews (data collection ongoing) were conducted to explore users’ cognitive and emotional reactions as they were using the risk calculator and immediately afterwards. All participants were adults with type 2 diabetes. Purposive sampling was used to recruit a varied sample in terms of gender, age, ethnicity, length of time since diagnosis, and internet use.
Results:
Evaluating the risk calculator against the best-practice checklist and focus group feedback identified several areas for improvement including better explanation of medical terms, displaying normal values, and altering the user journey. Cognitive and emotional reactions to the risk calculator included scepticism about its validity, demotivation, and relief.
Conclusions:
Adhering to best practices in risk communication and ensuring that users understand their individual risk are essential features of a risk calculator. However, conveying individual risk does not necessarily motivate or translate into behaviour change. This study has demonstrated the range of responses that people with type 2 diabetes have to cardiovascular risk calculators. These help to explain why risk calculators have not been shown to lead to behaviour change. Understanding how people respond when they use risk calculators can guide the development of next-generation risk calculators. One area for further research is to find ways to explain risk that bypass psychological defence mechanisms thus allowing risk information to be taken on-board without provoking undue anxiety.
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