Emphasizing the risks of avoiding breast cancer screening may be the best way to motivate women to get screened--at least for some ethnic groups, suggest the results of a study.
But public health officials tend to stress that screening can help save a woman's life, rather than stress the risk of not getting screened, that is that failing to detect breast cancer early can cost a woman her life.
"Community and governmental organizations involved in promoting cancer detection behaviors have resisted using messages that emphasize undesirable consequences," says lead study author Peter Salovey, of the department of psychology at Yale University.
The study results are published in the July issue of Health Psychology.
Why is stressing the risks of not getting a mammography most effect at motivating women to get one? Getting screened is inherently frightening since it exposes one to the risk of discovering cancer. Many women would rather avoid such unpleasantness unless they are reminded that the benefit of getting a mammography outweighs the risk of not getting one, according to the study.
Over 750 women over the age of 40 participated in the study. Most of the women were black, white, or Hispanic. They were randomly selected to watch either a video emphasizing the benefits of getting a mammogram, or a video emphasizing the risks of not getting one.
Some of these videos were also tailored along ethnic lines. A random selection of women watched videos depicting women of their ethnicity, and conveying breast cancer statistics targeted to their ethnicity. The rest of the women watched videos depicting women of different ethnic backgrounds.
The study participants were asked about their mammography use 6 and 12 months after participating in the study. Those who saw a multicultural (rather than ethnically targeted) video emphasizing the risks of not being screened were most likely to get mammograms over the next 6 months--if they were white or Hispanic, the researchers found.
The mammography rates among black study participants did not change significantly throughout the study period.
The effectiveness of the videos waned over the second half of the study period among white and Hispanic participants. "It may be that participants did not process the message deeply enough for them to recall the unique aspects of it twelve months after having seen it," Salovey says.
The researchers were surprised by another study finding: the multicultural videos were better at persuading white and Hispanic women to receive mammograms than those tailored to ethnicity. Again, this finding did not apply to the black study participants.
This finding suggests that "culture and ethnicity are more complex than what is implied by merely matching ethnically similar photographs and statistics to message recipients," Salovey says.
Future studies should tailor messages to women's specific concerns and beliefs about breast cancer and mammography, as well to as cultural and family issues, rather than simply targeting ethnicity, suggest the researchers.
Black study participants may have been unresponsive to the videos because of difficulty accessing mammography services. Future studies with black study participants should take a place in an environment that minimize such barriers, such as in mobile mammography clinics offering free screening, suggest the researchers.
This study was funded by grants from the American Cancer Society, the National Cancer Institute, the National Institute of Mental Health, and the Ethel Donaghue Women's Health Investigator Program at Yale University.
Health Psychology is the official, peer-reviewed research journal of the Division of Health Psychology (Division 38), American Psychological Association. For information about the journal, contact Arthur Stone, PhD, at 631-632-8833. For copies of the article, contact the Center for the Advancement of Health at 202-387-2829 or e-mail firstname.lastname@example.org.
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