Does Message Frame Influence Colorectal Cancer Screening Intentions among African Americans

Introduction:  Purpose is to identify which framed message activates African American adults to screen for colorectal cancer (CRC) who have not screened for CRC. Identifying which frame is the most effective trigger can improve the likelihood that African Americans exposed to the health message will initiate steps to screen for CRC.

Methods: African Americans recruited from a community health center were randomly assigned to view one of four video conditions (gain-frame peer, gain-frame expert, loss-frame peer, loss-frame expert) on CRC screening.  A pre/post survey was administered when viewing the video intervention. Survey asked questions about demographic characteristics, perceived risk, cancer worry, and intention to screen for CRC.  Univariate and bivariate analyses were conducted to describe the sample and identify framing effects.

Results: A total of 336 individuals participated in the study. Bivariate analyses found no statistically significant differences in demographics among members across the four study conditions. Analysis found no framing effects across the four conditions for intention to screen (p=.362) and perceived risk (p=.211) after controlling for loss-frame peer.  Only framing effect found in this analysis was for cancer worry where it approached significance (p=.056).  Within group analyses found gain-frame expert influenced cancer worry from pre- to post-test (D M=.30, p=.006).

Conclusion: Gain-frame expert messages were found to be most effective in influencing cancer worry among African Americans.  No other framing effects were found for intention and perceived risk.  Understanding that these differences exist enables CRC interventions to incorporate messages likely to stimulate African Americans to screen for CRC.