Communicating consequences of risky behaviors: Life expectancy versus risk of disease

Objective: We investigate (1) whether presenting consequences of health-related behaviors in terms of life expectancy, rather than risk of disease, improves recall and (2) if yes, through which underlying mechanisms; (3) whether these effects hold for both low- and high-numeracy people and (4) in two countries with different cultural environments and medical systems. Methods: Experiment within a computerized survey on probabilistic samples in the United States (n = 513) and Germany (n = 534). Results: When consequences of health-related behaviors were presented in terms of changes in life expectancy, recall was better than when they were presented in terms of risks of a disease both after 10 min, Cohen's h = .51, F(1,543) = 34.12, p = .001, and after 3 weeks, h = .62, F(1,543) = 48.98, p = .001. This was so for participants of both high and low numeracy, and in both countries. The improved recall seems to be due to better imaginability of changes in life expectancy. Conclusions: Consequences of health-related behaviors are easier to imagine and are recalled better when expressed as changes in life expectancy rather than as changes in risk of diseases. Practice implications: When communicating with patients about medical risks, we recommend using concepts that they can readily relate to their own everyday experiences. (C) 2010 Elsevier Ireland Ltd. All rights reserved.