Using patients’ narratives to promote colorectal cancer screening: a review and an experimental investigation
AbstractBackground: Patients’ narratives have been suggested as a promising way to promote health, including colorectal cancer (CRC) screening, but evidence about their effectiveness is mixed. Aims: a) to provide a comprehensive review of the literature, and b) to investigate the effect of narratives conveying different emotions in promoting CRC screening. Methods: a) Systematic review of studies investigating narratives in CRC screening; b) Between-participant design comparing: usual leaflet (no-narrative condition), usual leaflet and one of three narratives: the character is waiting for the result (control narrative), had a negative result (reassurance-based narrative) or had a positive result and was successfully treated for early-stage cancer (anticipated regret-based narrative). Participants: 145 participants aged 45-65, with no CRC personal history (approved by local Ethic Committee). Measures: intention to undergo CRC screening, knowledge, risk perception, and informed choice. Analyses: Logistic regressions and ANOVAs. Findings: a) Thirteen studies were included; Most were quantitative, USA-based, recent (last 5 years). The content of the narratives varied widely. b) The reassurance-based narrative yielded to the highest intention to undergo screening (85.7% vs. no-narrative condition 51.4%, OR=5.684, p=.003; vs. regret-based condition 59.5%, OR=4.091, p=.017; vs. control narrative 66.7%, OR=3.000, p=.066). The four conditions did not differ in knowledge, risk perception, and proportion of informed choices (p>.578). Discussion: Our findings suggest that not all narratives are alike in promoting CRC screening, and that FOBT may be better promoted by reassurance-based narratives. Moreover, adding narratives to currently used information material did not affect knowledge, risk perception and the proportion of informed choices.
Copyright (c) 2017 T. Gavaruzzi, M. Sarlo, F. Giandomenico, R. Rumiati, F. Polato, F. De Lazzari, L. Lotto
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