Communicating risk to promote colorectal cancer screening: a multi-method study to test tailored versus targeted message strategies

Abstract

Colorectal cancer (CRC) screening rates are suboptimal, partly due to poor communication about CRC risk. More effective methods are needed to educate patients, but little research has examined best practices for communicating CRC risk. This multi-method study tests whether tailoring CRC risk information increases screening intentions. Participants (N = 738) were randomized with a 2:2:1 allocation to tailored, targeted, and control message conditions. The primary outcome was intention to screen for CRC (yes/no). Additional variables include perceived message relevance, perceived susceptibility to CRC, and free-text comments evaluating the intervention. A chi-square test determined differences in the proportion of participants who intended to complete CRC screening by condition. A logistic-based path analysis explored mediation. Free-text comments were analyzed using advanced topic modeling analysis. CRC screening intentions were highest in the tailored intervention and significantly greater than control (P = 0.006). The tailored message condition significantly increased message relevance compared with control (P = 0.027) and targeted conditions (P = 0.002). The tailored condition also increased susceptibility (P < 0.001) compared with control, which mediated the relationship between the tailored condition and intention to screen (b = 0.04, SE = 0.02, 95% confidence interval = 0.02, 0.09). The qualitative data reflect similar trends. The theoretical mechanisms and practical implications of tailoring health education materials about CRC risk are discussed.

Educational interventions to improve bowel cancer awareness and screening in Organisation for Economic Co-operation and Development countries: A scoping review

“…Of those, 64.5 % completed screening. An online message study ( Neil et al, 2022 ) and text message study ( Alber and Glanz, 2018 ) both observed no significant differences in screening intentions between groups.…”

“…Eighteen studies used other educational interventions for screening education; a video (n = 2) ( Carcioppolo et al, 2020 , Lucas et al, 2021 ), Facebook promotion (n = 1) ( Lee-Won et al, 2017 ), audio (n = 1) ( Kennedy et al, 2018 ), online education (n = 2) ( Lucas et al, 2016 , Lucas et al, 2018 ), Facebook group (n = 1) ( Key et al, 2020 ), decision aid (n = 3) ( Gabel et al, 2020 , Woudstra et al, 2019 , Housten et al, 2020 ), theatre play (n = 1) ( Friedman et al, 2019 ), women’s health day (n = 1) ( McBride and Gesink, 2018 ), text message (n = 1) ( Alber and Glanz, 2018 ), online message (n = 2) ( Champion et al, 2018 , Neil et al, 2022 ), patient navigation (n = 1) ( Fernandez et al, 2022 ), and a newsletter (n = 2) ( Shepherd et al, 2022 , Leone et al, 2016 ). Five studies measured screening uptake ( Shepherd et al, 2022 , Leone et al, 2016 , Gabel et al, 2020 , Key et al, 2020 , Champion et al, 2018 ).…”

A Multimethod Evaluation of Tobacco Treatment Trial Recruitment Messages for Current Smokers Recently Diagnosed With Cancer: Pilot Factorial Randomized Controlled Trial

“…To form the map, themes are linked together with pathways that help to provide insight into whether the themes are connected. Previous studies have used Leximancer as a tool to triangulate qualitative data [ 33 ], analyze a large corpus of open-text data to identify markers of risk communication [ 34 ], and evaluate the mechanisms by which tailoring risk messages to promote colorectal cancer messages may be effective [ 35 ].…”