The proposed study's objective is to test a decision theory model of mammogram utilization, The model is drawn from Tversky and Kahneman's prospect theory, which posits that the frame of reference from which prospects are viewed, in terms of either potential gains or losses, determines the preference for a risk-seeking or risk-averse choice. In this case, obtaining a cancer check-up is regarded as a risk-seeking action. A field experiment will test two messages designed to persuade female family planning patients to have low-cost mammograms. Conducted in six community health clinics with approximately 600 female patients, the experiment will compare the effectiveness of a mammogram message stressing potential losses with a standard, message which stresses potential gains. Using a design in which all clinics implement the experimental message at differing points in time (allowing for within -1 as well as between-clinic comparisons), the study will examine the proportion of patients who opt for mammography, as well as beliefs, attitudes, and intentions regarding mammography. According to the framing postulate of prospect theory, patients who receive a, gain-frame message (e.g., 80% of breast symptoms are benign) should be less likely to opt for the mammogram than those who receive a loss-frame message (20% of breast' symptoms are malignant), even though the messages are factually identical. If' confirmed, the hypothesis would suggest that a reassuring posture with respect to. patients' health prospects may reduce rather than improve the likelihood of patients' subsequent health-care seeking actions.
