Evaluating the effect of frame and lexical valence on colon-cancer screening uptake

We evaluated the effectiveness of a message promoting colon-cancer screening with actual patients. Two factors were manipulated: verbal framing (gain vs. loss) and lexical valence of the consequences (expressing them with lexically positive vs. negative terms). Previous studies have almost always expressed the consequences of the promoted health behavior with lexically positive terms (e.g., conservative surgery) preceded by a negation term in the loss frame. However, psycholinguistic literature suggests that the message framing would be more effective when using terms lexically coherent (i.e., gain frame expressed with positive terms and loss frame expressed with negative terms, e.g., radical surgery). Based on the different effect that framed messages have depending on the function of the behavior promoted (i.e., detection vs. prevention), we predicted that: a) when promoting a detection behavior, the loss-negative message will be more effective than the loss-positive message, which is usually more effective than the gain-positive message; and b) when promoting a prevention behavior, the loss-negative message will be less effective than the loss-, which is usually less effective than the gain-positive. The results supported partially this prediction: The loss-negative message was more effective than the loss-positive message, but the loss-negative message was as effective as the gain-positive one. We propose that this result depends on the fact that the targeted behavior was described as both a detection and a preventive behavior for colon-cancer. These findings could both explain the weakness of the framing effect resulted in recent meta-analyses and inform cancer screening communication research and practice.