Age and framing effects on decision making related to advance care planning.
Objectives Advance care planning (ACP) can promote autonomy and reduce burden at the end of life, yet many people avoid it. Drawing on prospect theory, life-span theories, and decision-making frameworks, this preregistered study examined whether message framing (gain, loss, neutral) influenced ACP b...
| Published in: | Journals of Gerontology Series B: Psychological Sciences & Social Sciences Vol. 81; no. 8; pp. 1 - 13 |
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| Main Authors: | , |
| Format: | Article |
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Oxford University Press / USA
Aug2026
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=195931925&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 195931925 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 10795014 JGB jtl: Journals of Gerontology Series B: Psychological Sciences & Social Sciences issn: 10795014 maglogo: N pubinfo: dt: Aug2026 vid: 81 iid: 8 pid: 622 pub: Oxford University Press / USA artinfo: ui: 195931925 10.1093/geronb/gbag106 ppf: 1 ppct: 12 formats: tig: atl: Age and framing effects on decision making related to advance care planning. aug: au: Chen, Enna Y Löckenhoff, Corinna E affil: Department of Psychology, Stanford University, Stanford, California, United States Department of Psychology, Cornell University, Ithaca, New York, United States su: United States Self-evaluation Defense mechanisms (Psychology) Age distribution Communication Affect (Psychology) Advance directives (Medical care) Patient participation Information-seeking behavior Statistical power analysis Scale analysis (Psychology) Research funding Statistical sampling Multiple regression analysis Descriptive statistics Intention Patient decision making Case studies Confidence intervals Data analysis software Regression analysis sug: subj: Self-evaluation Defense mechanisms (Psychology) Age distribution Communication Affect (Psychology) Advance directives (Medical care) Patient participation Information-seeking behavior United States Marketing Research and Public Opinion Polling Statistical power analysis Scale analysis (Psychology) Research funding Statistical sampling Multiple regression analysis Descriptive statistics Intention Patient decision making Case studies Confidence intervals Data analysis software Regression analysis keyword: advance care planning Affect aged copyrightHolder:The Gerontological Society of America copyrightYear:2026 decision making End-of-life planning Health decisions https://dx.doi.org/10.1093/geronb/gbag106 Information avoidance inLanguage:en Message framing publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/42301908/ self-report terminally ill advance care planning Affect aged copyrightHolder:The Gerontological Society of America copyrightYear:2026 decision making End-of-life planning Health decisions https://dx.doi.org/10.1093/geronb/gbag106 Information avoidance inLanguage:en Message framing publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/42301908/ self-report terminally ill ab: Objectives Advance care planning (ACP) can promote autonomy and reduce burden at the end of life, yet many people avoid it. Drawing on prospect theory, life-span theories, and decision-making frameworks, this preregistered study examined whether message framing (gain, loss, neutral) influenced ACP behavioral intention, affective responses, and information avoidance, and whether these effects varied by age. Methods Five hundred U.S. adults aged 22–88 were randomly assigned to read a gain-framed, loss-framed, or neutral description of ACP. Participants completed self-report measures of ACP behavioral intention, affective responses, and information avoidance before and after the framing manipulation. Behavioral information avoidance was assessed only after the manipulation. Regression models tested framing effects and interactions with age. Results Participants in the loss-framed condition reported greater increases in ACP behavioral intention than those in the gain-framed condition. Age moderated the association between framing and behavioral information avoidance, such that older adults were more likely than younger adults to avoid ACP information in the gain condition, but not in the loss or neutral conditions. This age difference was evident for behavioral, but not self-reported, information avoidance. Discussion Loss framing may promote behavioral intention, whereas gain framing may increase information disengagement among older adults. This pattern suggests that ACP engagement may involve multiple decision stages and that framing may shape them through different mechanisms. The divergence between behavioral and self-reported avoidance highlights the value of assessing both forms of engagement. Findings also underscore the importance of considering life-span differences in ACP decision making. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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