DESCRIPTION (provided by applicant): Although considerable progress has been made in increasing women's use of mammography, nearly half of American women still fail to get routine mammograms according to the schedules recommended by public health organizations. Thus, interventions aimed at encouraging repeat mammography are more likely than ever before to reach women who have had at least one prior screening, and may have formed beliefs about the risks associated with mammography based on factors such as their experiences with past screenings. Research on message framing provides a particularly promising, theoretically-grounded framework for developing message-based interventions to promote routine mammography use, by specifying how the frame of a persuasive message (gain v. loss) should be tailored to match a woman's beliefs about the risks associated with obtaining a mammogram. Gain-framed messages present the benefits of obtaining a mammogram, and should be most effective in promoting screening among women who believe mammography to be a relatively risk-free, health-affirming behavior. In contrast, loss-framed messages present the risks of not obtaining a mammography, and should be most effective in promoting screening among women who believe mammography to be a relatively risky, illness-detecting behavior. The fundamental aims of the proposed study are 1) to demonstrate the effectiveness of an approach that matches the gain- vs. loss-frame of a persuasive message to a woman's unique beliefs about the risks associated with mammography, 2) to identify specific factors that shape women's beliefs about the risks associated with mammography, and 3) to identify mechanisms that may account for the increased persuasiveness of messages that are framed to match a woman's beliefs about the risks associated with mammography. The proposed study will test specific hypotheses relating to each of these aims using a sample of 356 women who are recruited from a primary care clinic and who are overdue for a mammography screening. Women's beliefs about mammography and breast cancer (BC), history of past screening, family history of BC, and motivational orientation will be assessed via questionnaire, and women will be randomly assigned to view either a gain- or loss-framed message promoting mammography. The effects of matching message frames to women's risk beliefs on subsequent mammography use will be assessed at a 3-month follow-up. The proposed research holds the promise of both refining relevant theory as well as innovating future interventions for promoting routine mammography use among women with varied screening histories and risk beliefs. Approximately 1 in 8 women will develop breast cancer at some point in her life, and treatment is most successful when breast cancer is discovered early. Although mammography is the most effective method of early detection, many American women remain non-adherent to recommendations for routine screening. The proposed research aims to develop a theoretically-guided approach to maximizing the persuasiveness of appeals that promote routine cancer screenings such as mammography. This individualized approach to message framing holds considerable promise in specifying useful guidelines that health professionals, educators, and future intervention researchers can use in developing effective message-based interventions for promoting routine mammography use.
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