Effects of Culturally Targeted Message Framing on Colorectal Cancer Screening Among African Americans

• Published in: Health psychology 2021-05, Vol.40 (5), p.305-315
• Main Authors: Lucas, Todd, Thompson, Hayley S., Blessman, James, Dawadi, Anurag, Drolet, Caroline E., Hirko, Kelly A., Penner, Louis A.
• Format: Article
• Language: English
• Subjects: African Americans; Aged; Arousal; Black or African American - psychology; Black or African American - statistics & numerical data; Black People; Cancer Screening; Colon Disorders; Colorectal cancer; Colorectal Neoplasms; Colorectal Neoplasms - ethnology; Colorectal Neoplasms - prevention & control; Cultural Competency; Cultural Sensitivity; Early Detection of Cancer - statistics & numerical data; Expectations; Female; Frame analysis; Framing Effects; Health Communication - methods; Human; Humans; Male; Medical screening; Messages; Middle Aged; Neoplasms; Occult Blood; Prevention; Racial inequality; Racism; Racism - psychology; Receptivity; Theory of planned behavior; Uptake
• ISSN: 0278-6133; 1930-7810
• DOI: 10.1037/hea0001073

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.