Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)



Committee Member

Dr. Leo Gugerty, Committee Chair

Committee Member

Dr. Richard Pak

Committee Member

Dr. Marissa Shuffler

Committee Member

Dr. Fred Switzer


Research in multi-attribute decision making and how people adapt strategy selection to changes in information suggest an influence of the task environment such as increases in task complexity, time pressure, or difficulty. Decisions made within a health context provide similar scenarios in which the environment can affect multi-attribute decision making strategies. This study sought to understand the influence of the seriousness and prevalence of a disease on decision outcomes and decision-making processes within the context of vaccination. Twenty-nine participants viewed eight hypothetical scenarios involving illnesses reported in the local area or associated with travel. In the scenarios, four illnesses were described that were either low or high in terms of the seriousness of the illness as indicated by the symptoms associated with them, and the scenarios either described an instance where there was a high or low prevalence of the illness in the area. Participants then used this information to evaluate a matrix displaying four possible vaccines as decision alternatives, each with four attributes that could be used to determine the benefits of the vaccine or the costs associated with them. A mixed-model analysis was used to examine the effects of seriousness and prevalence on choice and decision strategy. The hypothesis that high seriousness and prevalence would result in decisions favoring a more effective (and thus, more expensive) vaccine was supported. Additionally, the hypothesis that high seriousness and prevalence would lead to participants using strategies that focus on the beneficial attributes was also supported. However, this effect of prevalence was larger than predicted compared to seriousness.



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