The Role of Prospect Theory in Screening Behavior Decision-Making in a Health-Insured Population of South Africa
- Corresponding Author:
- Leegale Franscesca Adonis
University of the Witwatersrand
School of Public Health, 27 St. Andrews Rd
Parktown, Johannesburg, Gauteng 2193, South Africa
E-mail: [email protected]
Received date: May 04, 2015; Accepted date: October 07, 2015; Published date: October 15, 2015
Citation: Adonis L, Basu D, Luiz PJ (2015) The Role of Prospect Theory in Screening Behavior Decision-Making in a Health-Insured Population of South Africa. J Psychol Psychother 5:208. doi:10.4172/2161-0487.1000208
Copyright: © 2015 Adonis L, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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.