In this part of the experiment we ask you to imagine that you have chronic back ... There is no treatment available that can completely cure you, but there are two ...
Appendix A: Instructions and sample of choice lists Experimental instructions This experiment consists of two parts, Part 1 and Part 2. During this experiment you are not allowed to communicate with other participants. At any time during the experiment, you can raise your hand if anything is unclear. We will then come and answer your question in private. Your answers will remain anonymous. Other participants will not be able to see what answers you give. Please read the instructions and questions carefully. Back pain is a common health problem across all age groups. In this part of the experiment we ask you to imagine that you have chronic back pain. This means that: · You have moderate problems in walking about. · You have moderate problems performing your usual activities. (e.g. work, study, housework, family or leisure activities) · You have moderate pain or discomfort. You can find the description of chronic back pain on a card on your desk. There is no treatment available that can completely cure you, but there are two treatments that give you a temporary relief of your symptoms. Treatment A completely takes away the pain during one week. It does not improve your walking and usual activity problems. Treatment B also completely takes away the pain during one week. In addition, it allows you to walk with only slight problems and to perform your usual activities with no problems. You can find the descriptions of the effects of the two treatments on the cards on your desk. The effects of the treatments start immediately at the beginning of the treatment and last for exactly one week. After this you return to your usual health state with chronic back pain. You will be asked to make several choices between Treatment A and Treatment B. The questions differ in the starting time of the treatments. Usually Treatment B starts at a later date than Treatment A. Consider the following question as an example: Which option do you prefer, option A or option B?
Decreasing impatience for health outcomes Treatment A
Health
Timing
Your choice
A
Treatment B
B
state X
Health
Timing
state In 0 months + 1 day
□
□
Y
In 3 months + 1 day
You can indicate your choice by checking the corresponding box. Part 1 of this experiment consists of 3 lists of 48 questions each. In every list, option A remains the same, but option B varies. Option B varies only in the timing of the health improvement. Every list is put on two pages of 24 questions each. In the first row, you will choose option B, because it offers a larger improvement in health and both treatments start at the same time. As you move down the list, option B becomes less attractive because you have to wait longer before it starts. In some row, you will probably choose option A. If so, you will also choose option A in all rows below that one, because in these option B is less attractive. Similarly, if you choose option B in a given row, you will also choose option B in all rows above that one, because in these option B is more attractive. There are no right or wrong answers, we are only interested in your choices. To check whether you understand the procedure, please answer the following four questions: Question 1 Which treatment is better if they both start today? o Treatment A o Treatment B Question 2 Treatments A and B make the relief of symptoms last: o Forever o For exactly one week o Not sure Question 3 “Treatment B in 10 weeks” means: o The relief of symptoms in Treatment B lasts for 10 weeks o Treatment B starts after 10 weeks, and relief of symptoms lasts for 1 week Question 4 One week after starting Treatment A or Treatment B, you: o Go back to your usual health state without chronic back pain problems o Go back to your usual health state with chronic back pain problems o Not sure Part 1 starts on the next page. 2
Decreasing impatience for health outcomes
First part of List 1 Treatment A Health
Your choice
Treatment B Health
Timing
A
B
X
In 0 months + 1 day
□
□
Y
In 0 months + 1 day
X
In 0 months + 1 day
□
□
Y
In 1 month + 1 day
X
In 0 months + 1 day
□
□
Y
In 2 months + 1 day
X
In 0 months + 1 day
□
□
Y
In 3 months + 1 day
X
In 0 months + 1 day
□
□
Y
In 4 months + 1 day
X
In 0 months + 1 day
□
□
Y
In 5 months + 1 day
X
In 0 months + 1 day
□
□
Y
In 6 months + 1 day
X
In 0 months + 1 day
□
□
Y
In 7 months + 1 day
X
In 0 months + 1 day
□
□
Y
In 8 months + 1 day
X
In 0 months + 1 day
□
□
Y
In 9 months + 1 day
X
In 0 months + 1 day
□
□
Y
□
□
Y
□
□
Y
□
□
Y
□
□
Y
□
□
Y
□
□
Y
□
□
Y
state
X
X
X
X
X
X
X
In 0 months + 1 day
In 0 months + 1 day
In 0 months + 1 day
In 0 months + 1 day
In 0 months + 1 day
In 0 months + 1 day
In 0 months + 1 day
state
Timing
In 10 months + 1 day In 11 months + 1 day In 12 months + 1 day In 13 months + 1 day In 14 months + 1 day In 15 months + 1 day In 16 months + 1 day In 17 months + 1 day
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Decreasing impatience for health outcomes Part 2
Now we move on to Part 2, which is similar to Part 1 except for one important aspect. Instead of imagining that you have chronic back pain yourself, we now ask you to imagine that a group of 50 students (not including you) has chronic back pain. You don’t know any of these students. This means that: · They have moderate problems in walking about. · They have moderate problems performing your usual activities. (e.g. work, study, housework, family or leisure activities) · They have moderate pain or discomfort. You can still find the description of chronic back pain on a card on your desk. There is no treatment available that can completely cure them, but there are two treatments that give them a temporary relief of them symptoms. Treatment A completely takes away the pain during one week. In addition, it allows them to walk with only slight problems and to perform their usual activities with no problems. However, this treatment is expensive and can only be given to 40 of the 50 students. The other 10 students get no treatment. Treatment B generates the same health effects as Treatment B, but is cheaper and can be given to all 50 students. You can find the descriptions of the effects of the two treatments on the card labeled ‘Treatment B” on your desk. The effects of the treatments start immediately at the beginning of the treatment and last for exactly one week. After this you return to your usual health state with chronic back pain. You will be asked to make several choices between Treatment A and Treatment B. The questions differ in the starting time of the treatments. Usually Treatment B starts at a later date than Treatment A. Consider the following question as an example: Which option do you prefer, option A or option B?
Treatment A Amount of students treated 40
Your choice Timing
A
B
In 0 months + 1 day
□
□
Treatment B Amount of students treated 50
Timing In 3 months + 1 day
You can indicate your choice by checking the corresponding box.
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Decreasing impatience for health outcomes
Part 1 of this experiment consists of 3 lists of 48 questions each. In every list, option A remains the same, but option B varies. Option B varies only in the timing of the health improvement. Every list is put on two pages of 24 questions each. In the first row, you will choose option B, because it offers the same health improvement to a larger group of students, and both treatments start at the same time. As you move down the list, option B becomes less attractive because the students have to wait longer before the treatment starts. In some row, you will probably choose option A. If so, you will also choose option A in all rows below that one, because in these option B is less attractive. Similarly, if you choose option B in a given row, you will also choose option B in all rows above that one, because in these option B is more attractive. There are no right or wrong answers, we are only interested in your choices. The first choice list will appear on the next page.
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Decreasing impatience for health outcomes
First part of List 1 Treatment A Amount of students treated 40
Your choice
Amount of Timing
In 0 months + 1
In 0 months + 1 day
40
In 0 months + 1 day
40
In 0 months + 1 day
40
In 0 months + 1 day
40
In 0 months + 1 day
40
In 0 months + 1 day
40
In 0 months + 1 day
40
In 0 months + 1 day
40
In 0 months + 1 day
40
In 0 months + 1 day
40
In 0 months + 1 day
40
A
B
students
Timing
treated
day 40
Treatment B
In 0 months + 1 day
□
□
50
In 0 months + 1 day
□
□
50
In 1 month + 1 day
□
□
50
In 2 months + 1 day
□
□
50
In 3 months + 1 day
□
□
50
In 4 months + 1 day
□
□
50
In 5 months + 1 day
□
□
50
In 6 months + 1 day
□
□
50
In 7 months + 1 day
□
□
50
In 8 months + 1 day
□
□
50
In 9 months + 1 day
□
□
50
□
□
50
□
□
50
In 10 months + 1 day In 11 months + 1 day In 12 months + 1 day
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Decreasing impatience for health outcomes
Part 3 Please imagine the following situation and answer the questions. Suppose you win 10 certificates, each of which can be used (once) to receive a “dream restaurant night.” On each such night, you and a companion will get the best table and an unlimited budget for food and drink at a restaurant of your choosing. There will be no cost to you: all payments including tips come as part of the prize. The certificates are available for immediate use, starting tonight, and there is an absolute guarantee that they will be honored by any restaurant you select if they are used within a two-year window. However if they are not used up within this two-year period, any that remain are valueless. The questions below concern how many of the certificates you would ideally like to use in each year, how tempted you would be to depart from this ideal, and what you expect you would do in practice: a. From your current perspective, how many of the ten certificates would you ideally like to use in year 1 as opposed to year 2? Year 1:…… Year 2:…… b. Some people might be tempted to depart from their ideal allocation in question a. Which of the following best describes you: (please mark only one) □ I would be strongly tempted to keep more certificates for use in the second year than would be ideal. □ I would be somewhat tempted to keep more certificates for use in the second year than would be ideal. □ I would have no temptation in either direction (skip to question d) □ I would be somewhat tempted to use more certificates in the first year than would be ideal. □ I would be strongly tempted to use more certificates in the first year than would be ideal. c. If you were to give in to your temptation, how many certificates do you think you would use in year 1 as opposed to year 2? Year 1:…… Year 2:……
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Decreasing impatience for health outcomes d. Based on your most accurate forecast of how you think you would actually behave, how many of the nights would you end up using in year 1 as opposed to year 2? Year 1:…… Year 2:…… Finally, we would like to ask you a few questions about yourself: • How many hours per week, on average, do you do sports? ______ hour(s) • Do you smoke any cigarettes (cross what applies to you)? □ Yes, I smoke every now and then □ Yes, I smoke every day □ No • How many days per week, on average, do you drink alcohol? ______days • On the day(s) that you drink alcohol, how many glasses do you drink on average? ______glasses • What is your length? ______cm • What is your weight? ______kg • Are you living in the same house as your parents? Yes / No • What is your nationality? _____________________ • Do you save any money? Yes / No If yes, on average how much do you save per month? _____________________ Please read the following statements carefully and indicate to what extent they apply to you. • Whether something is convenient for me or not, to a large extent determines the decisions that I take or the actions that I undertake. Strongly disagree □ □ □ □ □ □ □ □ 1 2 3 4 5 6 7 8
Strongly agree
• I wish I would do sports more often than I do currently. Strongly disagree □ □ □ □ □ □ □ □ 1 2 3 4 5 6 7 8
Strongly agree
• I should do sports more often than I do currently. Strongly disagree □ □ □ □ □ □ □ □ 1 2 3 4 5 6 7 8
Strongly agree
• I study regularly. 8
Decreasing impatience for health outcomes
Strongly disagree □ □ □ □ □ □ □ □ 1 2 3 4 5 6 7 8
Strongly agree
• I wish I would study more regularly. Strongly disagree □ □ □ □ □ □ □ □ 1 2 3 4 5 6 7 8
Strongly agree
• I should study more regularly. Strongly disagree □ □ □ □ □ □ □ □ 1 2 3 4 5 6 7 8
Strongly agree
• I am always well-prepared in class. Strongly disagree □ □ □ □ □ □ □ □ 1 2 3 4 5 6 7 8
Strongly agree
• I wish I would be better prepared in class. Strongly disagree □ □ □ □ □ □ □ □ 1 2 3 4 5 6 7 8
Strongly agree
• I should be better prepared in class. Strongly disagree □ □ □ □ □ □ □ □ 1 2 3 4 5 6 7 8
Strongly agree
• I have a tendency to postpone tasks. Strongly disagree □ □ □ □ □ □ □ □ 1 2 3 4 5 6 7 8
Strongly agree
Please raise your hand if you are done with this questionnaire, and remain silent.
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