Effects of Ethnicity and Message Framing on Colorectal Cancer Screening

Abstract

We examined the relative effectiveness of gain- versus loss-framed videotaped messages designed to increase colorectal cancer (CRC) screening among low-income Caucasians, African Americans, and Mexican Americans. The participants were 164 people living in low-income neighborhoods. Participants watched either a gain-framed or a loss-framed videotape. They completed pre- and post-video questionnaires and received a take-home immunoassay Fecal Occult Blood Test (iFOBT) kit that they were asked to use and return by mail. Multivariate logistic regression analyses indicated that iFOBT return rates varied significantly by ethnicity (p < .002) and framing condition (p < .004). Screening kits were returned by 68.4% of Caucasians, 37.7% of African Americans, and 64.8% of Mexican Americans; 65.0% of participants who saw the gain-framed video returned the iFOBT kit, but only 50.0% of those who saw the loss-framed video returned the kit. Framing made a difference only for Caucasians, and the direction of the difference was opposite from the direction predicted. The return rate for Latinos was similar to that for Caucasians; however, Latino rates did not vary as a function of type of framing. It is possible that message framing must be specifically targeted if it is to be effective for Latinos and African Americans.