Effects of culturally targeted message framing on colorectal cancer screening among African Americans.

Abstract

Objective: This study examined how standard and culturally targeted versions of gain and loss-framed messaging affect African Americans' colorectal cancer (CRC) screening receptivity and behavior, as well as their anticipation of experiencing racism in undertaking CRC screening. Method: Screening-deficient African Americans (N = 457) viewed an informational video about CRC risks, prevention, and screening and were randomized to receive a gain or loss-framed message about screening. Half of participants viewed an additional culturally targeted message about overcoming racial disparities in CRC by obtaining screening. Using the Theory of Planned Behavior, we measured general receptivity to CRC screening. We also measured arousal of anticipatory racism in response to messaging. Finally, we offered participants a no-cost fecal immunochemical testing kit (FIT Kit) and measured uptake and use. Results: Message framing interacted with culturally targeted messaging to affect CRC screening receptivity and behavior. Participants were no more receptive to CRC screening when standard loss-framing was used, but were more favorable if loss-framing was culturally targeted. Targeted loss-framing also reduced anticipatory racism, which partially mediated effects on screening receptivity. Finally, although participants least often accepted a FIT Kit with standard loss-framing, effects of messaging on FIT Kit uptake and use were not significant. Conclusion: This study adds to growing recognition of important cultural nuance in effective use of message framing. Current finding also suggest that targeted and framed messaging could synergistically impact the extent to which African Americans engage in CRC screening, although specific impacts on FIT Kit screening are less certain.

Culturally targeted message framing and colorectal cancer screening preferences among African Americans.

“…These findings underscore not only the potential of loss-frames to promote risk tolerance; thereby, compelling individuals to take psychologically “risky” actions (Kahneman, 2003; Rothman & Salovey, 1997; Kahneman & Tversky, 1979), but also the capacity of targeted messaging to make loss-framing culturally relevant (Lucas et al, 2016, 2021). Taken together, these findings carry implications for effective health communication across various CRC screening contexts (Rothman et al, 2020).…”

“…Next, participants were randomly assigned to receive a 1-min gain-framed or loss-framed video about the importance of CRC screening. Half of participants viewed an additional culturally targeted message that focused on overcoming adversity through personal will and the role of personal control in obtaining CRC screening and overcoming CRC disparities (Lucas et al, 2021; Neighbors et al, 1995). Participants then reported desired thoroughness—“When selecting a CRC screening exam, I would most prefer an option that is less convenient, but more thorough” (1 = strongly agree , 7 = strongly disagree )—and rank-ordered their preferences for colonoscopy every 10 years, sigmoidoscopy every 5 years, and annual FIT screening.…”

Message framing for men? Gender moderated effects of culturally targeted message framing on colorectal cancer screening receptivity among African Americans.

“…The data analyzed were collected as part of larger study examining the effects of message framing and culturally targeted messaging on receptivity to CRC screening among African Americans. Participants and procedures for recruitment and administering CRC video education and message manipulations are therefore largely identical to the previous description (Lucas et al, 2021).…”

“…We also considered whether these messaging strategies would differentially impact arousal of racism-related thinking among African American men and women when considering CRC screening. Based on recent research (Lucas et al, 2016(Lucas et al, , 2021, we anticipated that African Americans would be most receptive to CRC screening when loss-framing was used, but only if this message was culturally targeted. Of greater interest, and since African American men may be especially hesitant to participate in CRC screening due, we predicted that targeted loss-framed messaging use would more strongly influence CRC screening receptivity for men than women.…”

Addressing Global Cancer Care Inequities Using Implementation Science and Community-Engaged Research Approaches

“…42 For example, research suggests that culturally-targeted communication strategies, including message framing and communitycentred cancer control interventions, can be used to address disparities for specific populations with increased disease burden. [43][44][45] Indeed, patient-centred interventions and equitable delivery tools are necessary to ensure feasible and acceptable solutions, 46 recognising the need for capacity building in many resourceconstrained settings. For example, the successful implementation of the human papillomavirus vaccine into the routine immunisation delivery strategy in Tanzania can serve as a model for future efforts centred on low-cost and highimpact solutions to reduce the burden of cancer and address disparities.…”