African-Americans are at a substantially increased risk of both developing and dying from colorectal cancer (CRC). This costly disparity can be largely attributed to African-Americans'diminished use of available CRC screenings. Although early detection of CRC via screening is highly beneficial, efforts to encourage their use among African-Americans have not been successful, suggesting a critical need to develop and evaluate effective health messaging strategies. In turn, health communication research has advocated the use of both loss-framed messaging and also personal prevention messaging to encourage illness detection b behaviors. However, the capacity of these messaging strategies to encourage CRC screening among African-Americans is not well understood. This includes limited knowledge about the potential of such messages to interface with perceptions of racism and medical mistrust that can impede screening behavior, and also whether loss-framed and personal prevention messages can be simultaneously employed to better promote CRC screening among African-Americans. The long-term goal of the proposed research is to develop health communications that reduce significant and costly ethnic health disparities, and to reveal psychological processes that underlie effective health messaging for ethnic minorities. The immediate objective of this application is to identify how gain and loss-framed messaging, as well as personal prevention messaging, may be used to reduce CRC screening disparities among African-Americans. The central hypothesis is that African-Americans will be best compelled to obtain screening for CRC when messages simultaneously emphasize personal prevention and are loss-framed.
The specific aims are to 1) identify and compare effects of stand-alone gain versus loss- framed health messaging on African-Americans'CRC screening attitudes, intentions, and behavior;2) identify and compare effects of gain versus loss-framed health messaging on African-Americans'perceived racism and medical mistrust;3) determine the effect of coupling gain and loss-framed messages with a culturally-targeted personal prevention message on African-Americans'CRC screening attitudes, intentions, and behavior. The proposed research will develop and administer for unique versions of a CRC informational and screening video communication. These videos will be used to experimentally evaluate the effects of stand-alone and coupled loss-framed and personal prevention health messages on CRC screening attitudes, intentions, and behavior in a local sample of African-Americans. The proposed research will also identify the effects of health messages on perceived racism and medical mistrust. The public health implications of this project are significant. Namely, the proposed research will provide knowledge that is critical for developing and evaluating useful approaches to ethnic minority health messaging, and for better understanding how best to encourage cancer detection behaviors among African-Americans.

Public Health Relevance

The proposed research will evaluate how broad-spectrum and culture-specific health messaging strategies can be combined to better promote colorectal cancer screening among African-Americans. The proposed research carries important public health implications in proposing to identify health communications that reduce a significant and costly ethnic health disparity, and in examining psychological processes that underlie effective health messaging for ethnic minorities.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
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Special Emphasis Panel (ZRG1-HDM-X (56))
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Blake, Kelly D
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Wayne State University
Family Medicine
Schools of Medicine
United States
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