Testing the content for a targeted age‐relevant intervention to promote cervical screening uptake in women aged 50–64 years

Abstract

Objectives. Low uptake of cervical screening in women in their 50s and 60s leaves them at elevated risk of cancer in older age. An age-targeted intervention could be an effective way to motivate older women to attend cervical screening. Our primary objective was to test the impact of different candidate messages on cervical screening intention strength. Design.A cross-sectional online survey with randomized exposure to different candidate messages.Methods. Women aged 50-64 years who were not intending to be screened when next invited were recruited through an online panel. Those meeting the inclusion criteria (n = 825) were randomized to one of three groups: (1) control group, (2) intervention group 1, (3) intervention group 2. Each intervention group saw three candidate messages. These included a descriptive social norms message, a diagram illustrating the likelihood of each possible screening outcome, a response efficacy message, a risk reduction message and an acknowledgement of the potential for screening discomfort. We tested agetargeted versions (vs. generic) of some messages. The primary outcome was screening intention strength.Results. After adjusting for baseline intention, social norms (p = .425), outcome expectancy (p = .367), risk reduction (p = .090), response efficacy (p = .136) and discomfort acknowledgement messages (p = .181) had no effect on intention strength. Age-targeted messages did not result in greater intention than generic ones.Conclusions. There was no evidence that a single message used to convey social norms, outcome expectancy, risk reduction or response efficacy had an impact on intention strength for older women who did not plan to be screened in future.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Do age-targeted messages increase cervical screening intentions in women aged 50–64 years with weak positive intentions? A randomised control trial in Great Britain

“…These findings suggest it is unlikely any single message can strengthen screening intentions for those with weak intentions to begin with and are similar to our previous study with women who did not intend to be screened (Marlow et al, 2021). The results of the present study contrast with cognitive dissonance theory (Festinger, 1957;Byskov Petersen et al, 2020) as we found no support that messages which were ineffective for women with negative intentions might work better for those who were more positively inclined towards screening (Marlow et al, 2021). There are important potential confounders associated with age, such as comorbidity, that could impact screening behaviour, which would be useful to measure in a future study.…”

“…There was no significant difference between the age-targeted messages and generic messages. This was similar to the findings of our previous study (Marlow et al, 2021), but inconsistent with the theory that targeted messages are more effective than generic ones (Kreuter and Wray, 2003). We also tested different message formats (negative or positive framing of the response efficacy message and short-and longterm time frames for the risk reduction message), and neither were more effective.…”

“…Our aim was to test the impact of five theory-informed messages designed to increase intention to attend cervical screening among 50-64-year-old women who had weak positive intentions to be screened, extending our previous work (Marlow et al, 2021). We found no single message was superior in increasing intention to attend cervical screening, although small but significant increases were observed after exposure to three messages.…”

“…In our previous study (TARGET) we tested the impact of five messages on intention to attend screening among women aged 50-64 years who did not plan to be screened when next invited (Marlow et al, 2021). Age was used to determine targeted messages, as this is currently the only factor used to target communications in the national screening programme.…”

“…We aimed to repeat our previous study (TARGET; (Marlow et al, 2021)) with women who had weak positive intentions to attend cervical screening, testing the same theory-informed messages.…”