Multidimensional Measure of Informed Choice [MMIC-16]

Description

The Multidimensional Measure of Informed Choice (MMIC-16) is a specialized research instrument developed by Marteau, Dormandy, and Michie (2001) to assess informed choice within the context of health-related decision-making.

The original application of the instrument focused on decisions made by pregnant women regarding participation in prenatal screening for Down syndrome. The MMIC is based on the principle that an informed choice involves more than simply receiving health information. Rather, it reflects the combination of adequate knowledge, personal attitudes, and the decision or behavior ultimately adopted by the individual.

Structure of the Questionnaire

The MMIC-16 consists of 16 items, organized into two main scales.

The first scale comprises 10 knowledge items and assesses participants’ understanding of information related to prenatal screening.

The second scale consists of 6 attitude items and evaluates the individual’s positive or negative attitude toward screening.

The combination of knowledge, attitudes, and the individual’s actual choice provides a framework for determining whether a health-related decision can be considered informed.

Objective

The primary objective of the MMIC-16 is to systematically assess whether a health-related decision is made with adequate knowledge and in accordance with the individual’s personal values and attitudes.

The instrument can also contribute to evaluating the effectiveness of information provision and counseling preceding a health decision and to examining the quality of decision-making within patient-centered healthcare.

Scoring and Statistical Analysis

The knowledge component contains 10 items, with one point awarded for each correct response. According to the scoring approach described in the original material, a score of 5 or higher indicates a higher level of knowledge.

The attitude component consists of 6 items assessed using a Likert-type response scale. The resulting score is used to determine whether the participant holds a more positive or negative attitude toward prenatal screening.

Data obtained through the MMIC-16 may be examined using descriptive and inferential statistical methods. Reliability and validity analyses may also be conducted depending on the objectives and methodological design of the study.

Reliability and Validity

The original material reports satisfactory levels of internal consistency. Specifically, Cronbach’s alpha was 0.70 for the 10-item scale and 0.76 for the 6-item scale, indicating acceptable reliability for the respective dimensions.

The subsequent validation study by Michie, Dormandy, and Marteau (2002) provided additional support for the multidimensional conceptualization and measurement of informed choice.

Contemporary Research Relevance

The concept of informed choice remains highly relevant within modern patient-centered care and shared decision-making. Contemporary healthcare increasingly emphasizes not only whether patients receive appropriate information, but also whether they understand that information and whether their eventual decisions are consistent with their personal attitudes and preferences.

Accordingly, the conceptual framework underlying the MMIC may provide a useful approach for investigating decision-making processes across different areas of healthcare. However, adaptation of the instrument to other clinical contexts, populations, languages, or cultures should be accompanied by appropriate linguistic, cultural, and psychometric validation.

References

Marteau, T. M., Dormandy, E., & Michie, S. (2001). A measure of informed choice. Health Expectations, 4(2), 99–108.

Michie, S., Dormandy, E., & Marteau, T. M. (2002). The multi-dimensional measure of informed choice: A validation study. Patient Education and Counseling, 48(1), 87–91.

Koepke, S., Solari, A., Rahn, A., Khan, F., Heesen, C., & Giordano, A. (2018). Information provision for people with multiple sclerosis. Cochrane Database of Systematic Reviews, (10).