The effect of conflicting versus consistent messaging on older women’s support for breast cancer screening cessation

IF 3.1 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Patient Education and Counseling Pub Date : 2025-05-01 Epub Date: 2025-01-20 DOI:10.1016/j.pec.2025.108675

Nancy L. Schoenborn , Sarah E. Gollust , Craig E. Pollack , Mara A. Schonberg , Cynthia M. Boyd , Qian-Li Xue , Rebekah H. Nagler

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Abstract

Objective

Breast cancer over-screening is common in older women. Messaging about breast cancer screening cessation may reduce over-screening but the broader informational environment often emphasizes screening continuation. We aimed to examine the effect of receiving consistent messages about breast cancer screening cessation versus conflicting messages (i.e., receiving messages about screening cessation and screening continuation from different sources).

Methods

In a two-wave survey experiment with 3809 women 65 + years from a U.S. population-based online panel, we randomized participants to a) no messages, b) consistent messages promoting screening cessation, or c) conflicting messages – a message promoting screening continuation followed by a message promoting screening cessation.

Results

The conflicting message group had significantly lower support for screening cessation in a hypothetical older woman (mean 3.87 [SD 2.00] on 7-point scale, 95 % CI 3.76–3.97) compared with the consistent message group (mean 4.17 [SD 1.99], 95 % CI 4.08–4.28), but was still significantly higher than the control group (mean 2.68 [SD 1.87], 95 % CI 2.54–2.82, p’s < 0.001). Message effects on self-screening intentions were similar. Participants reported low rates of confusion, distrust or ambivalence.

Conclusions

Messaging about screening cessation can significantly increase older women’s support for screening cessation, with low rates of negative reactions, even if there are competing messages on continued screening.

Practice implications

Messaging about screening cessation can be incorporated into clinical discussions or used in conjunction with other interventions aimed at reducing over-screening.

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信息冲突与信息一致对老年妇女支持停止乳腺癌筛查的影响

目的：乳腺癌过度筛查在老年妇女中很常见。停止乳腺癌筛查的信息可能会减少过度筛查，但更广泛的信息环境往往强调继续筛查。我们的目的是检查接收关于乳腺癌筛查停止的一致信息与冲突信息（即从不同来源接收关于筛查停止和筛查继续的信息）的效果。方法：在一项针对3809名年龄在 + 岁的女性的两波调查实验中，我们将参与者随机分配到a)没有信息，b)一致的信息促进筛查停止，或c)冲突的信息-一个信息促进筛查继续，然后一个信息促进筛查停止。结果：与一致信息组（平均4.17 [SD 1.99], 95 % CI 4.08-4.28）相比，冲突信息组对假设的老年妇女筛查戒烟的支持度显著降低（7分制平均3.87 [SD 2.00], 95 % CI 3.76-3.97），但仍显著高于对照组（平均2.68 [SD 1.87], 95 % CI 2.54-2.82, p' ）。关于停止筛查的信息可以显著增加老年妇女对停止筛查的支持，负面反应率很低，即使在继续筛查方面存在竞争信息。实践意义：关于停止筛查的信息可纳入临床讨论，或与旨在减少过度筛查的其他干预措施结合使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Patient Education and Counseling 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

11.40%

发文量

384

审稿时长

46 days

期刊介绍： Patient Education and Counseling is an interdisciplinary, international journal for patient education and health promotion researchers, managers and clinicians. The journal seeks to explore and elucidate the educational, counseling and communication models in health care. Its aim is to provide a forum for fundamental as well as applied research, and to promote the study of organizational issues involved with the delivery of patient education, counseling, health promotion services and training models in improving communication between providers and patients.