When is it OK to Joke? Adding humor to fear-based colonoscopy screening messages may increase compliance

Abstract

Large scale campaigns frequently use humor to increase compliance with colonoscopy screening recommendations. Problematically, we know little about how humor functions to influence screening. This study seeks to understand whether and how messages framed using humor appeals function differently from those using fear appeals to increase colonoscopy intentions. An online experiment (N = 186) was conducted comparing colonoscopy screening messages framed with a fear appeal and mixed humor/fear appeal. The addition of humor was more effective among those with high frequency of cancer worry, whereas the fear appeal resulted in significantly higher response efficacy, which was in turn associated with increased colonoscopy intentions. These results begin to describe situations in which intervention messages framed with a mixed humor/fear appeal may be more or less effective than interventions framed with fear appeals alone. Practical and theoretical implications for persuasive message design are discussed.

Using Facebook to promote the uptake of colorectal cancer screening

“…Our data suggest that some people may be turning to Facebook for 'lighter content'; as such, planners may wish to avoid any fear-based messaging. Interestingly, Carcioppolo et al [33] explored the addition of humour to fear-based messages about colonoscopy screening and tested these online using Amazon's Mechanical Turk platform. The authors found that messages with a mixed appeal (fear and humour combined) may be more effective at increasing screening intentions than fear-based messaging alone among those with high cancer worry [33].…”

“…Interestingly, Carcioppolo et al [33] explored the addition of humour to fear-based messages about colonoscopy screening and tested these online using Amazon's Mechanical Turk platform. The authors found that messages with a mixed appeal (fear and humour combined) may be more effective at increasing screening intentions than fear-based messaging alone among those with high cancer worry [33]. This may suggest that the addition of humour may soften fear-based messaging that may otherwise scare the target audience.…”

“…The one message that included humour in our study also had a mixed appeal with the perceived barriers construct and reactions to this message led to a recommendation of proceed with caution. Additionally, Carcioppolo et al [33] identified opportunities for audience segmentation including among those with high cancer worry which may be more receptive to mixed appeal messages. Further exploration regarding which segment of social media users would engage with mixed appeal messaging is needed.…”

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

“…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 ).…”

“…Varied intervention formats compared the framing of messages to improve screening intentions or uptake including video (n = 2) ( Carcioppolo et al, 2020 , Lucas et al, 2021 ), Facebook promotion (n = 1) ( Lee-Won et al, 2017 ), and an online education module (n = 2) ( Lucas et al, 2016 , Lucas et al, 2018 ). Loss-framed messaging consistently improved screening uptake or intentions in five studies ( Carcioppolo et al, 2020 , Lee-Won et al, 2017 , Lucas et al, 2021 , Lucas et al, 2016 , Lucas et al, 2018 ) and was more effective compared to gain-framed messaging. Facebook promotion study ( Lee-Won et al, 2017 ) and a video study ( Carcioppolo et al, 2020 ) both found loss-framed messaging was associated with colonoscopy intentions through inducing fear.…”