Vignette Responses and Future Intentions in a Health Decision-Making Context: How Well Do They Correlate?

Introduction: Vignettes are commonly used to assess health care decision making when it is impractical or unethical to use experimental methods. We sought to determine whether decisions made in response to hypothetical vignettes requiring medical decisions for self or parents related to reported future likelihoods of engaging in similar behaviors. Method: Respondents (n = 1,862) were adults recruited in person in general community settings. Individuals were assigned randomly to read 1 of a variety of vignettes that presented various medical problems being experienced either by oneself or a parent in a hypothetical context. Individuals reported their likelihoods of hiring a health care advocate to perform a variety of tasks in the context of the vignette and their likelihoods of hiring a health care advocate for themselves or their own parents in the future. Multigroup analysis was performed to estimate a latent variable path model for the vignette hiring questions and real-world future intention to hire by condition. Results: The configural model was retained. Tests of invariance for the correlation between future intentions to hire and the latent variable from the vignette decision making indicated a significant difference between self and parent conditions. However, moderate relationships existed between vignette responses and future intentions in both conditions, with approximately 25% of the variance in personal, future intentions being accounted for by vignette responses. Discussion: Our findings support the continued study of vignettes as a possible tool to measure behavioral intentions in the context of positive and negative health care decisions impacting self and others.