Prevalence and predictors of medical information avoidance: a systematic review and meta-analysis

Abstract

Background: Medical information avoidance-the prevention or delay of acquiring health-related information-is a growing concern for physicians, healthcare professionals, and policymakers. Yet, its prevalence and predictors have remained poorly understood.

Purpose: We conducted a systematic review and meta-analysis to clarify the prevalence and predictors of medical information avoidance, offering key insights into the worldwide empirical evidence.

Methods: We performed a systematic search, preregistered on the OSF and in accordance with PRISMA and MOOSE reporting guidelines. Additional individual participant datasets were obtained from the National Institutes of Health (NIH). Data analysis was performed using random--effects and mixed-effects models.

Results: A total of 92 studies and 6 individual participant datasets (564 497 unique participants, 25 countries) were analyzed. We found that almost 1 in 3 participants avoided or were likely to avoid information. Specifically, we estimated prevalence rates of 24% for diabetes, 29% for cancer, 32% for HIV, 40% for Huntington's disease, and 41% for Alzheimer's disease. We did not find any reliable association with gender or with race and ethnicity. Instead, we identified 16 significant predictors across cognitive, health-related, and sociodemographic domains. The strongest predictors were all cognitive: information overload (r = 0.26), perceived stigma (r = 0.36), self-efficacy (r = -0.28), and trust in the medical system (r = -0.25).

Conclusions: Nearly 1 in 3 participants avoided or were likely to avoid medical information. The highest prevalence rates were found for Huntington's disease and Alzheimer's disease, 2 incurable neurodegenerative diseases. Key cognitive predictors suggest entry points for policy interventions and future research.

Lay summary: Medical information is more accessible than ever, but many people choose to avoid it. How common is this behavior, and what predicts it? To find out, we analyzed data from over 90 studies involving more than half a million people across 25 countries. We found that nearly 1 in 3 people avoided or were likely to avoid medical information. Avoidance was highest for incurable neurodegenerative diseases (Alzheimer's disease: 41%, Huntington's disease: 40%), moderate for severe but treatable conditions (HIV: 32%, cancer: 29%), and lowest for a chronic, manageable illness (diabetes: 24%). We identified 16 key predictors of medical information avoidance. Surprisingly, gender, race, and ethnicity were not among them. Instead, the strongest predictors were cognitive and emotional: mistrust in the medical system, feeling overwhelmed, low confidence in managing one's health, and fear of being judged. Patterns of avoidance varied across world regions, suggesting that differences in healthcare systems may influence behavior. In this study, we do not judge whether medical information avoidance is good or bad. Instead, we offer the first comprehensive review of how common it is and what predicts it. More research is needed to understand the psychological and medical consequences of avoiding medical information.

Keywords: health behavior; medical information avoidance; meta-analysis; predictors; prevalence; systematic review.

Figure 1.

PRISMA flowchart of the study selection process, detailing the number of reports and datasets identified, screened, assessed for eligibility, and included in the meta-analysis, with reasons for exclusions at each stage.

Figure 2.

Conceptual model for the predictors of medical information avoidance (A) and description of the data: (B) geographic distribution, (C) predictors per information avoidance type, and (D) diseases per region.

Figure 3.

Prevalence of medical information avoidance with 95% confidence intervals (CIs) for cancer (A), HIV (B), Huntington’s disease (C), diabetes (D), and Alzheimer’s disease (E). Box sizes represent weights in meta-analytic estimates.