Messaging Strategies to Reduce Breast Cancer Over-screening in Older Women

Study Overview
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Brief Summary
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This is an online survey experiment with data collection over 2 time points two weeks apart. This is Aim 2 of a three-aim R01 project; overall project goal is to better understand how messages from different sources interact to affect older women's breast cancer screening decisions. In this current project, the investigators propose to test the effect of combined exposure to a clinician message + a message from another source (i.e. family/friend or media) on older women's breast cancer screening beliefs, attitudes, and intentions.

Detailed Description
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In a two-wave national online survey experiment, the investigators will randomly assign 3,000 women 65 years or older without personal history of breast cancer to 6 groups, including two control groups and four experimental groups. The experimental groups will read a message at Time 1 (T1) that may be from either family/friend or the media followed by a second message from a clinician one to two weeks later at Time 2 (T2). The clinician message will be directed at reducing over-screening, mentioning the harms of over-screening and supporting screening cessation. The investigators will systematically vary the non-clinician message to be either consistent with the clinician message (also mentions harms of over-screening and supports screening cessation) or conflicting (mentions benefits of screening, supports continued screening and opposes screening cessation). The investigators include a no-exposure control group (Group 1) where the participants read no message at either time point and will only be asked the assessment questions. The investigators also include a single exposure group that reads only the clinician message (Group 2).

Official Title
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Messaging Strategies to Reduce Breast Cancer Over-screening in Older Women

Conditions
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Breast Cancer Screening

Intervention / Treatment
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* Other: messages


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Part of an online survey panel called KnowledgePanel able to complete survey in English Exclusion Criteria: Personal history of breast cancer

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Group 1 - control (no exposure)<br>No message at T1 or T2. | |
| Other: Group 2 - control (single exposure)<br>Single clinician message at T1 aimed at reducing over-screening. No message at T2. | Other: messages<br>* Different messages describing either the benefits of breast cancer screening aimed at supporting continued screening or messages describing the harms of over-screening and making recommendations to stop screening<br>|
| Experimental: Group 3<br>T1 - message from media source aimed at reducing over-screening. T2 - message from clinician aimed at reducing over-screening | Other: messages<br>* Different messages describing either the benefits of breast cancer screening aimed at supporting continued screening or messages describing the harms of over-screening and making recommendations to stop screening<br>|
| Experimental: Group 4<br>T1 - message from a close family member aimed at reducing over-screening. T2 - message from clinician aimed at reducing over-screening | Other: messages<br>* Different messages describing either the benefits of breast cancer screening aimed at supporting continued screening or messages describing the harms of over-screening and making recommendations to stop screening<br>|
| Experimental: Group 5<br>T1 - message from media source aimed at supporting continued screening. T2 - message from clinician aimed at reducing over-screening | Other: messages<br>* Different messages describing either the benefits of breast cancer screening aimed at supporting continued screening or messages describing the harms of over-screening and making recommendations to stop screening<br>|
| Experimental: Group 6<br>T1 - message from a close family member aimed at supporting continued screening. T2 - message from clinician aimed at reducing over-screening | Other: messages<br>* Different messages describing either the benefits of breast cancer screening aimed at supporting continued screening or messages describing the harms of over-screening and making recommendations to stop screening<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Breast cancer screening intention for a hypothetical patient in survey vignette assessed by score on a scale | Screening intention for a hypothetical patient; assessed by score on a 7 point likert scale question developed by the investigators. | Immediately after reading the assessment question | 
| Breast cancer screening intention for participant assessed by score on a scale | Screening intention assessed by score on a 7 point likert scale question developed by the investigators. | Immediately after reading the assessment question | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Breast cancer screening attitude on mammogram importance as assessed by score on a scale | Attitude toward mammogram importance; assessed by score on a 5 point likert scale question developed by the investigators. | Immediately after reading the assessment question | 
| Breast cancer screening attitude on benefits of mammograms as assessed by score on a scale | Attitude toward mammogram benefits; assessed by score on a 5 point likert scale question developed by the investigators. | Immediately after reading the assessment question | 
| Breast cancer screening attitude on mammogram being worthwhile as assessed by score on a scale | Attitude toward mammogram being worthwhile; assessed by score on a 5 point likert scale question developed by the investigators. | Immediately after reading the assessment question | 
| Message effectiveness toward thinking about getting a mammogram as assessed by score on a scale | Message effectiveness toward thinking carefully about getting a mammogram; assessed by a 5 point likert scale question developed by the investigators. | Immediately after reading the assessment question | 
| Message effectiveness toward finding out more about the benefits of a mammogram as assessed by score on a scale | Message effectiveness toward finding out more information about the potential benefits of getting a mammogram; assessed by a 5 point likert scale question developed by the investigators. | Immediately after reading the assessment question | 
| Message effectiveness toward finding out more about downsides of getting a mammogram as assessed by score on a scale | Message effectiveness toward finding out more information about the potential downsides of getting a mammogram; assessed by a 5 point likert scale question developed by the investigators. | Immediately after reading the assessment question |