Communicating probabilities of cervical cancer screening results with icon arrays vs. tree diagrams: a longitudinal experiment

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• dc.contributor.author Okan, Yasmina
• dc.contributor.author Stone, Eric R.
• dc.contributor.author Petrova, Dafina
• dc.contributor.author Bruine de Bruin, Wändi
• dc.date.accessioned 2025-01-29T16:13:22Z
• dc.date.embargoEnd info:eu-repo/date/embargoEnd/2026-05-11
• dc.date.issued 2024
• dc.description.abstract Simple graphical displays such as icon arrays and tree diagrams have been proposed for communicating health risks and supporting informed decisions. The UK's National Health Service (NHS) uses tree diagrams to communicate the chances of different cervical cancer screening results, but their effectiveness has not been compared to icon arrays. We conducted a well-powered longitudinal experiment involving 3,100 UK women eligible for cervical screening (25-64 years) to examine the effectiveness of icon arrays to communicate possible cervical screening results, relative to the UK NHS's tree diagram and to a numerical-only format. We also examined whether the presence (vs. absence) of explanatory text referring to different types of results (i.e. distinguishing between HPV positive results with vs. without abnormal cervical cells) moderated effects of presentation format. Presentation format did not affect verbatim or gist knowledge of probabilities at initial assessment (i.e. immediately after participants viewed the displays), but icon arrays were associated with better gist knowledge of absolute magnitudes than tree diagrams and numerical-only formats at 1-month follow-up. Participants exposed to icon arrays also perceived lower likelihood of adverse screening results and reported stronger screening intentions at initial assessment. For displays without explanatory text, icon arrays were also associated with more positive user evaluations and less negative affective reactions than tree diagrams at initial assessment. Overall, our findings suggest that icon arrays support enduring knowledge of approximate magnitudes of probabilities and are better suited than tree diagrams for communicating possible screening results.
• dc.description.sponsorship This work was supported by a Population Research Fellowship awarded by Cancer Research UK awarded to Yasmina Okan [reference C57775/A22182]. Yasmina Okan’s time was additionally funded by a Ramón y Cajal Fellowship [RYC2020-028857-I] financed by MICIU/AEI/10.13039/501100011033 and by The FSE Invests in your Future. Dafina Petrova was supported by a Juan de la Cierva Fellowship [IJC2019-039691-I] funded by MICIU/AEI /10.13039/501100011033 and a Miguel Servet Fellowship [CP23/00024] from the Health Institute Carlos III. Wändi Bruine de Bruin is supported by the USC Schaeffer Center for Health Policy and Economics. The funding agreements ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report.
• dc.embargo.liftdate 2026-05-11
• dc.format.mimetype application/pdf
• dc.identifier.citation Okan Y, Stone ER, Petrova D, Bruine W. Communicating probabilities of cervical cancer screening results with icon arrays vs. tree diagrams: a longitudinal experiment. Health Commun. 2024; 11:1-13. DOI: 10.1080/10410236.2024.2421612
• dc.identifier.doi http://dx.doi.org/10.1080/10410236.2024.2421612
• dc.identifier.issn 1041-0236
• dc.identifier.uri http://hdl.handle.net/10230/69370
• dc.language.iso eng
• dc.publisher Taylor & Francis
• dc.relation.ispartof Health Commun. 2024; 11:1-13
• dc.relation.projectID info:eu-repo/grantAgreement/ES/2PE/RYC2020-028857-I
• dc.relation.projectID info:eu-repo/grantAgreement/ES/2PE/IJC2019-039691-I
• dc.rights © This is an Accepted Manuscript of an article published by Taylor & Francis in Health Communication on 11 Nov 2024, available online: http://www.tandfonline.com/10.1080/10410236.2024.2421612.
• dc.rights.accessRights info:eu-repo/semantics/embargoedAccess
• dc.subject.other Coll uterí--Càncer
• dc.title Communicating probabilities of cervical cancer screening results with icon arrays vs. tree diagrams: a longitudinal experiment
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion