Preferred Cognitive Styles and Health Decision-Making
One overarching strategy, first outlined in our 2011 commentary, is the Preferred Cognitive Styles and Health Decision-Making Model. A cognitive style is best understood as the basic thinking or cognitive strategy that an individual uses to make decisions—particularly under conditions of uncertainty—based on, among other things, cultural frames and beliefs. This style affects how an individual hears and conceptualizes information, and therefore can influence or drive how an individual perceives the issue at hand and how that person then behaves.
Individuals may process and make decisions with just one cognitive style, whereas others might have a primary, secondary, and tertiary cognitive style. Because these preferred cognitive styles so deeply affect how individuals process and react to information, it is imperative that HCWs learn to identify and use appropriate communication and education strategies for each type of style.
We expanded on many of these communication strategies in an earlier article. Among these include Prochaska and DiClemente's Transtheoretical Model, which outlines stages of change in behaviors. In the Transtheoretical Model, behavior change is conceptualized as a process that unfolds over time and involves progression through a series of five stages: precontemplation, contemplation, preparation, action, and maintenance."By understanding each of these stages and their importance, we can assist patients who are not even considering vaccination to accept vaccines to protect their health throughout their lifetime." With an understanding of where a patient is in the stages of change, this information, along with understanding the preferred cognitive style of the patient, can guide the conversation in which HCWs engage their patients.
The Health Belief Model is another communication strategy that may be helpful in assisting with behavior change in the area of vaccine acceptance. This model suggests that individuals make health decisions based on "perceived susceptibility to disease, perceived severity of disease, perceived benefits of preventive action, perceived barriers to preventive action." By addressing these issues through the patient's preferred cognitive style, we enter into a deeper and more richly informative and trust-building discussion with the patient.