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Updated: Jun 2, 2026
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Multimedia Battery for Assessment of Cognitive and Basic Skills in Mathematics (BM-PROMA)
Published on: August 28, 2021
Do low-numeracy people avoid shared decision making?
Mirta Galesic1, Rocio Garcia-Retamero
1Center for Adaptive Behavior and Cognition, Max Planck Institute, Berlin, Germany.
Summary
Patient preferences for shared decision-making vary by numeracy skills, country, and age. Low numeracy patients often prefer less involvement, highlighting the need for tailored communication strategies in healthcare.
Area of Science:
- Health Services Research
- Patient Engagement
- Health Communication
Background:
- The shift from paternalistic medical decision-making to shared decision-making (SDM) is increasing.
- However, patient desire for participation in healthcare decisions and factors influencing it remain unclear.
- Previous studies lack generalizability due to non-probabilistic sampling.
Purpose of the Study:
- To investigate patient preferences for SDM in relation to numeracy skills.
- To explore how these preferences differ across countries (US and Germany) and age groups.
- To address limitations of prior research by using probabilistic national samples.
Main Methods:
- A survey was conducted on national probabilistic samples in the United States and Germany.
- Participants were categorized by low and high numeracy skills.
- Usual and preferred roles in medical decision-making were assessed.
Main Results:
- A significant portion of low-numeracy individuals (US: 35%, Germany: 30%) desired a more passive role in decision-making.
- High-numeracy individuals generally expressed satisfaction with their current level of involvement.
- Nationality and age influenced preferences, with Americans being more active than Germans, and middle-aged individuals preferring more activity.
Conclusions:
- Patient preferences for shared decision-making are significantly associated with numeracy, nationality, and age.
- Educational interventions to improve numeracy and the use of non-quantitative communication are recommended.
- These strategies can help increase the involvement of low-numeracy patients in their healthcare decisions.
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