Psychological Traits and the Persuasiveness of Lung Cancer Screening Health Messages

Background: Lung cancer screening remains underused despite its proven mortality benefit. Health systems have attempted to increase screening awareness through advertising. Psychological theories suggest that construal level (a personal orientation toward the big picture or the details) and regulatory focus (goals emphasizing acquisition of a good or avoidance of a bad outcome) play a key role in health advertising effectiveness. These theories have not been examined in a screen-eligible population. Methods: Using Amazon's crowdsourcing platform, Mechanical Turk, we identified screen-eligible individuals based on US Preventive Services Task Force criteria. We randomly assigned participants to see 1 of 4 screening advertisement images in a 2 (construal level: high vs low) × 2 (regulatory focus: promotion vs prevention) between-subjects experimental design. We assessed willingness to undergo screening after the advertisement. Results: One hundred ninety-one individuals responded to our study invitation (mean age, 61 years). We found that the high construal/promotion focus image led to a greater willingness to screen compared with images representing other psychological states (P = .04). Regarding the personality traits of our respondents, high construal/promotion focus was the most prevalent (40%) trait combination, whereas low construal/prevention focus was the least prevalent (17%). Conclusions: The psychological focus of health-related messages affects an individual's willingness to undergo lung cancer screening. Individuals eligible for lung cancer screening are more persuaded by “big picture” messages describing the benefits of screening. Health systems may use this knowledge to design more effective patient-facing communications that lead to higher rates of screening.