Patient education and counseling · 2026
Effect of gain- and loss-framed messages on women's responses to negative family cancer history screening results: A randomized online trial.
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Guan Yue, Marra Angelo, Liu Yuan, Leon Dayanna Ramirez, Zhang Angela, Escoffery Cam, McCullough Lauren E, McBride Colleen M
Аннотация
OBJECTIVE: To examine whether gain- versus loss-framed messages affect women's responses to negative family cancer history (FCH) screening results, and whether these effects differ by race.
METHODS: From March to April 2025, we conducted a two-arm parallel-group randomized online trial of message framing (gain vs. loss), stratified by race (Black, non-Hispanic vs. non-Black), among U.S. women aged 40 years and older who screened negative on FCH (N = 655) recruited through the Ipsos nationally representative consumer panel. Participants were blinded to message-framing condition, completed a baseline survey, then viewed either a gain- or loss-framed message. The primary outcomes were understanding of inherited and general cancer risk, acceptance of the negative FCH screening result, and intentions to undergo mammography and update family history. Chi-square tests, ANOVA, and multivariable regression models examined message effects and race-by-framing interactions.
RESULTS: Of 655 participants, 61% were Black, non-Hispanic (n = 400) and 39% were non-Black (n = 255). Black participants reported higher mammogram screening intention but lower result understanding and result acceptance than non-Black participants. Message framing was not significantly associated with understanding, acceptance, or behavioral intentions (all p > 0.10), and framing effects did not significantly differ by race (all interaction p-values > 0.34); an exploratory analysis identified a non-significant trend toward higher acceptance of loss-framed messages among Black participants (mean difference = 0.56, p = 0.075).
CONCLUSIONS: In a nationally representative sample in which the majority of participants were Black, brief message framing alone did not influence women's responses to negative FCH results. As family history risk assessment expands in public health practice, equitable communication of negative results appears to require more than optimizing message wording. Future research should test simple, low cost communication strategies that actively engage patients and address result comprehension in population-based screening settings.
METHODS: From March to April 2025, we conducted a two-arm parallel-group randomized online trial of message framing (gain vs. loss), stratified by race (Black, non-Hispanic vs. non-Black), among U.S. women aged 40 years and older who screened negative on FCH (N = 655) recruited through the Ipsos nationally representative consumer panel. Participants were blinded to message-framing condition, completed a baseline survey, then viewed either a gain- or loss-framed message. The primary outcomes were understanding of inherited and general cancer risk, acceptance of the negative FCH screening result, and intentions to undergo mammography and update family history. Chi-square tests, ANOVA, and multivariable regression models examined message effects and race-by-framing interactions.
RESULTS: Of 655 participants, 61% were Black, non-Hispanic (n = 400) and 39% were non-Black (n = 255). Black participants reported higher mammogram screening intention but lower result understanding and result acceptance than non-Black participants. Message framing was not significantly associated with understanding, acceptance, or behavioral intentions (all p > 0.10), and framing effects did not significantly differ by race (all interaction p-values > 0.34); an exploratory analysis identified a non-significant trend toward higher acceptance of loss-framed messages among Black participants (mean difference = 0.56, p = 0.075).
CONCLUSIONS: In a nationally representative sample in which the majority of participants were Black, brief message framing alone did not influence women's responses to negative FCH results. As family history risk assessment expands in public health practice, equitable communication of negative results appears to require more than optimizing message wording. Future research should test simple, low cost communication strategies that actively engage patients and address result comprehension in population-based screening settings.