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Framing preventive care messaging and cervical cancer screening in a health-insured population in South Africa: implications for population-based communication?

journal contribution
posted on 2023-06-09, 06:31 authored by Leegale Adonis, Jithen Paramanund, Debashis Basu, John Da Silva LuizJohn Da Silva Luiz
The impact of health message framing on cervical cancer screening uptake is poorly understood. We undertook a prospective randomized control study between August 2013 and February 2014 within a health-insuered population. The study consisted of 748 females, aged 21–65?years who had not had a Pap smear in the previous 3?years and were randomly selected to receive either a loss-framed, gain-framed, or neutral health message (control) regarding cervical cancer screening via email. Pap smear uptake was determined from medical claims data. The median age was 43?years (interquartile range: 26–60?years). Overall Pap smear screening rate was found to be 8.36?percent (confidence interval: 8.08%-8.64%). Screening rate in the control group was 9.58?percent (confidence interval: 9.29%-9.87%), 5.71?percent (confidence interval: 5.48%-6.98%) in the gain-framed group, and 8.53?percent (confidence interval: 8.24%-8.81%) in the loss-framed group. Statistically there was no difference between the screening rates of the groups (p?=?0.75). Females were 43?percent (odds ratio?=?0.57) less likely to have a Pap smear if exposed to a gain-framed message, compared to a neutral-framed message; however, this finding was non-significant (p?=?0.13). When receiving a loss-framed message, females were only 23?percent (odds ratio?=?0.87) less likely to have a Pap smear compared to a neutral-framed message, also not significant (p?=?0.69). In addition, further age stratification revealed no differences in Pap smear uptake between different age groups. These findings indicate that Pap smear uptake in this health-insured population is low, with no difference in exposure to differently framed health messages when emailed. Framing of health messages may not be a significant consideration when constructing population-based communication through emails.


Publication status

  • Published


Journal of Health Psychology




Sage Publications

Department affiliated with

  • Business and Management Publications

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Peer reviewed?

  • Yes

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