Designing Effective and Appropriate Opt-Out Approaches for Patient Outreach
Mené sur 883 femmes (âge moyen : 59,13 ans), cet essai compare la performance de deux stratégies pour améliorer la participation au dépistage du cancer du sein par mammographie : l'une consistant à inviter toutes les patientes éligibles (opt-out), l'autre consistant à n'inviter que les patientes ayant accepté de bénéficier d'une mammographie après un appel téléphonique de sensibilisation automatisé (opt-in)
Despite considerable efforts to increase breast cancer screening, completion rates remain suboptimal across patient populations. Prior work has confirmed that we cannot rely solely on clinician visits to increase participation in preventive cancer screenings, and organized population health efforts directed to patients are a potentially promising pathway to increase uptake. However, many of these programs use conventional forms of engagement, relying on information and education alone to promote behavior change.Insights from the field of behavioral economics have shown that humans have predictable and systematic biases in decision-making that are often followed by decisions that are inconsistent with long-term goals. For example, status quo bias is a preference to maintain prior decisions. In the absence of strongly held preferences, individuals are biased toward inertia, or the action that will occur if one does nothing. Decisions are also affected by the way choices are framed. To change behavior, we can change the default (the choice that occurs if no action is taken) and the framing of choices from opt-in to opt-out. For example, when employers changed the default for retirement savings from an opt-in to an opt-out approach, employee participation in retirement savings significantly increased.
JAMA Internal Medicine , éditorial, 2022