Testing the effects on information use by older versus younger women of modality and narration style in a hospital report card

Background
Hospital report cards (HRCs) are usually presented in a textual and factual format, likely hampering information processing.

Objective
This study aimed to investigate the effects of audiovisual and narrative information in HRCs on user responses, and to test differences between older and younger women.

Design
A 2 (modality [textual vs. audiovisual]) × 3 (narration style [factual vs. process narrative vs. experience narrative]) online experiment was conducted. Information about breast cancer care was used as a case example. Age (younger [<65] vs. older [≥65]) was included as a potential effect modifier.

Setting and Participants
A total of 631 disease-naïve women (_Mage = 56.06) completed an online survey. The outcomes were perceived cognitive load, satisfaction, comprehension, information recall and decisional conflict. Data were analysed using AN(C)OVAs.

Results
Audiovisual (vs. textual) information resulted in higher information satisfaction across age groups, but was associated with lower comprehension in older women. An experience narrative (vs. factual information) increased satisfaction with attractiveness and emotional support of the information only in older women. A three-way interaction effect was found, suggesting that older women were most satisfied with the comprehensibility of audiovisual factual or textual process narrative information. Younger women were most satisfied with the comprehensibility of audiovisual process narrative or textual factual information.

Discussion and Conclusion
Audiovisual and narrative information in an HRC showed beneficial effects on satisfaction measures. In particular, audiovisual information could be incorporated into HRCs to increase satisfaction with information.

Public Contribution
Lay persons helped in optimizing the visuals used in the stimulus materials by checking for clarity.