Effects of Message Framing and Risk Feedback on CRC Screening

描述(由申请人提供)：美国需要继续努力增加结直肠癌(CRC)筛查。对于许多人来说，他们的筛选决定将受到互联网上信息的影响。这种有影响力的信息可以包括接收定制的CRC反馈。然而，一个主要的担忧是，收到在线定制的结直肠癌风险反馈，人们认为这是低风险的，可能会降低筛查的积极性。然而，正如这里所说的，当与适当的说服性信息搭配时，较高和较低的感知风险都可以激励筛查。为此，将定制的CRC风险反馈与收益或损失成帧配对--强调筛查的好处(即，收益)或不筛查的成本(即，损失)的信息--可能是促进筛查的有力组合。根据展望理论，高CRC风险的反馈与丢帧消息以及低风险反馈与增益帧消息的匹配应该比相反的配对(即错配)更有说服力来激励筛选。然而，还没有研究测试定制的CRC风险反馈和消息帧之间的匹配来影响CRC筛查。这项研究的主要目的是检验在获得CRC风险和在线(即，互联网)框架信息的个人的背景下，比较风险水平(即，一个人的风险与其他人的风险相比如何)与框架和效果的框架和中介之间的匹配。为了模拟这种在线环境，使用一家专门进行基于网络的研究的公司，我们将获得760名年龄在50-75岁之间的从未接受过结直肠癌筛查的人的样本。个人将审查关于结直肠癌筛查的在线信息，并收到关于其结直肠癌风险因素和相对风险水平的量身定制的反馈。然后，比较风险各阶层的参与者将被随机接受关于CRC筛查的好处(增益帧)或不筛查的缺点(丢帧)的消息。他们将立即完成干预后调查，评估筛查和假设调解人的意图，并在六个月后提供有关筛查行为的数据。这项研究解决了尚未解决和被忽视的问题，即什么是最好的定制信息，可以向CRC较低和较高的人提供能够促进CRC筛查的信息。为此，这项研究将是 首次在网上探索定制的CRC风险反馈和消息框架之间的匹配，以影响CRC筛查意图、行为和潜在的效果中介。这项工作很重要，因为目前尚不清楚通过互联网提供量身定制的CRC风险反馈以影响CRC筛查的最佳策略。

DESCRIPTION (provided by applicant): Continued efforts are needed in the U.S. to increase colorectal cancer (CRC) screening. For many people, their decision to screen will be influenced by information found on the internet. Such influential information can include receipt of tailored CRC feedback. However, a major concern is that receipt of online tailored CRC risk feedback that people interpret as being low risk can demotivate screening. Yet, as argued here, both higher and lower perceived risk can motivate screening when paired with appropriate persuasive messaging. To this end, pairing tailored CRC risk feedback with gain or loss framing - messages that highlight the benefits of screening (i.e., gain) or the costs of not screening (i.e, loss) - can be a potent combination to promote screening. As informed by Prospect Theory, matching of feedback of higher CRC risk with loss-framed messages as well as lower risk feedback with gain-frame messages should be more persuasive to motivate screening than the opposite pairings (i.e., mismatch). Yet no research has tested the matching between tailored CRC risk feedback and message framing to influence CRC screening. The primary goal of this study is to test the matching between level of comparative risk (i.e., how one's risk compares to others) and framing and mediators of effects in the context of individuals who obtain CRC risk and framing messages online (i.e., Internet). To simulate this online environment, using a firm the specializes in the conduct of web-based studies, we will obtain a sample of 760 individuals ages 50-75 who have never been screened for CRC. Individuals will review online information about CRC screening and receive tailored feedback as to their CRC risk factors and level of comparative risk. Participants within each stratum of comparative risk will then be randomized to receive messages either about the benefits of CRC screening (gain-frame) or the disadvantages of not screening (loss-frame). They will complete an immediate post-intervention survey assessing intentions to screen and hypothesized mediators and provide data six months later about screening behaviors. This study addresses the unresolved and neglected problem of what are the best tailored messages to give people at lower and higher CRC that can promote CRC screening. To this end, this study will be the first to explore in the online context the matching between tailored CRC risk feedback and message framing to influence CRC screening intentions, behaviors, and potential mediators of effects. This undertaking is important because it is yet unclear what best strategies to use to deliver tailored CRC risk feedback via the Internet to influence CRC screening.