How Do Australians' Attitudes to Diagnostic Testing and Screening Risks Relate to Health Literacy, Broader Health...

We investigated Australian adults' attitudes to diagnostic testing and screening risks and the associations of these attitudes with (i) broader healthcare beliefs, (ii) health literacy, (iii) perceived healthiness, and (iv) demographic characteristics. These associations were poorly understood, hindering the development of much-needed communication strategies explaining medical testing risks to lay people.

We conducted an online, cross-sectional survey of adults (18+) living across Australia. Adjusted multivariate regression analysis examined predictors of the perceived importance of querying risks when offered diagnostic and screening tests. Bivariate analysis examined test risk perceptions in relation to four clinical scenarios.

Most (86% of n = 774) participants believed it important to query risks when offered tests. Greater perceived importance of querying risks was predicted by being female, older, greater perceived healthiness, greater perceived ability to appraise health information, and stronger belief in holistic health. We identified complex relationships between risk perceptions regarding specific tests and perceived importance of querying their risks.

Our findings highlight new directions for communication strategies about medical testing risks. They include targeting broader belief systems that influence testing choices, promoting health literacy skills, and relying less on risk-benefit statistics. Our findings also highlight potential communication pitfalls.

Our insights matter for improving public health messaging and shared decision-making. They suggest that the norm of providing risk/benefit information might not adequately support individuals in making informed testing choices. It is also important to focus on the ways that individuals think about tests and on fostering their skills and empowerment.