If you want to effectively encourage African American patients to be screened for colon cancer, accentuate the positive. According to new research, emphasizing the risks of late detection can actually make them less likely to have the test.
“We have typically assumed that one of the best ways to motivate individuals is to point out disparities in health, but instead of motivating people who would be less likely to get these services in the first place, we may be driving them away,” observes lead author Robert A. Nicholson, PhD, assistant professor of neurology and psychiatry at Saint Louis University.
Nicholson and colleagues conducted a double-blind, randomized trial among 300 African American adults (Cancer Epidemiol Biomarkers Prev. 2008;17:2946-2953). Participants were asked to read one of four versions of a mock newspaper article and then answer questions about their likelihood of getting screened.
The articles varied in the way they framed and interpreted the same race-specific mortality data. One stressed the impact of the colon cancer on the African American community. Two others focused on racial disparities compared with whites, either currently or over time. The fourth, “Blacks making great strides against colon cancer,” emphasized progress.
On a scale of 1-5, those who read the “progress” article were significantly more likely to want to be screened than those who read the “impact” article or either “disparity” article.
Early screening for African Americans has taken on extra urgency since the American Cancer Society’s latest statistical report, Colorectal Cancer Facts & Figures 2008-2010. The report finds that black patients are more likely than whites to be diagnosed at later stages of the disease. Consequently, the American College of Gastroenterology urges screenings begin at age 45 for blacks, five years earlier than its recommendation for whites.