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Targeting and tailoring message-framing: the moderating effect of racial identity on receptivity to colorectal cancer screening among African–Americans

Abstract

This study demonstrates the potential of racial identity to moderate how gain and loss-framed messaging, as well as culturally-targeted messaging, can affect receptivity to preventive health screening. African–Americans (N = 132) who were noncompliant with recommended colorectal cancer (CRC) screening completed a measure of racial identity centrality—encompassing the extent to which racial identity is a core component of self-concept—and then participated in an online education module about CRC screening, during which either gain or loss-framed messaging was introduced. Half of African–Americans were also exposed to a culturally-targeted self-help message about preventing CRC. Theory of Planned Behavior measures of attitudes, normative beliefs, perceived behavioral control, and intentions to obtain a CRC screen served as outcomes. Results confirmed that effects of messaging on receptivity to CRC screening depended on racial identity. Among low racial identity African Americans, gain-framed messaging most effectively increased normative beliefs about obtaining CRC screening, whereas among high racial identity African Americans loss-framed messaging was most compelling. However, these effects most strongly emerged when culturally-targeted self-help messaging was included. We discuss implications for health disparities theory and research, including a potential to simultaneously deploy culturally-targeted and tailored messaging based on racial identity.

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Fig. 1

Notes

  1. Although participants were randomly assigned, a one-way ANOVA conducted during preliminary analysis also revealed that racial identity scores significantly differed across the four experimental cells (F (3, 128) = 3.069, p = .030). To further ensure fidelity, all statistical analyses were repeated using within-cell standardized scores for racial identity. The subsequently described results were not significantly affected by this standardization. For simplicity, we report only the results without standardization.

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Acknowledgements

This research was supported by a Wayne State University Research Enhancement Program Grant awarded to the first author.

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Correspondence to Todd Lucas.

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Todd Lucas, Mark Manninig, Lenwood W. Hayman Jr, and James Blessman declare that they have no conflict of interest.

Human and animal rights and Informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Lucas, T., Manning, M., Hayman, L.W. et al. Targeting and tailoring message-framing: the moderating effect of racial identity on receptivity to colorectal cancer screening among African–Americans. J Behav Med 41, 747–756 (2018). https://doi.org/10.1007/s10865-018-9933-8

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  • DOI: https://doi.org/10.1007/s10865-018-9933-8

Keywords

  • Message-framing
  • Colorectal cancer
  • Culturally-targeted
  • Tailored messaging
  • Illness detection
  • Health disparities
  • African–American
  • Theory of planned behavior
  • Racial identity