New Research Summary: Increasing Black men's colorectal screening

Dr. Todd Lucas, C.S. Mott Endowed Professor of Public Health at Michigan State University, is part of a talented team studying ways of reducing cancer in men. We sat down with Dr. Lucas to discuss their new article in published in the Psychology of Men and Masculinities about message framing for colorectal screenings for Black men.

Full citation: Lucas, T., Rogers, C. R., Aspiras, O., Manning, M., Dawadi, A., & Thompson, H. S. (2023). Message framing for men? Gender moderated effects of culturally targeted message framing on colorectal cancer screening receptivity among African Americans. Psychology of Men & Masculinities. Advance online publication. https://doi.org/10.1037/men0000418

What were the key questions you were addressing in this article?

Our team uses health psychology and health communication to try and address racial health disparities in the here and now. A key piece of this involves designing and evaluating culturally targeted education and communication to enhance the use of early detection tools, like cancer screening. In this article, we were interested in evaluating variability in responses to health communication aimed at improving colorectal cancer screening among African Americans. Although much has been made of cross-race differences in response to health communication, the potential for within race-differences is very often overlooked. Differences between African American women and men in their responses to health communication are a potentially very important piece of this variability.

What were the main conclusions of your article?

A large body of theory and research has highlighted that loss-framed messaging (in which the potential consequences of failing to act are emphasized) better compels participation in recommended cancer screening than gain-framed messaging (in which the potential benefits of taking action are emphasized). In recent work, we have highlighted an important race difference in effects of this messaging approach. Among African Americans, loss-framed messaging can indeed provide a beneficial and theoretically predicted nudge towards engaging the use of colorectal cancer screening, but only if loss-framing is overlaid with an effective culturally targeted message. In fact, generic or “off-the-shelf” loss-framed messaging that is not culturally targeted holds a potential to adversely impact cancer screening among African Americans, and this may be attributable to arousal of racism-related thoughts and emotion that can result from negatively valanced loss-framing.

In this article, we highlight an important potential difference between African American women and men. Although compelling to both sexes, enhanced receptivity to colorectal cancer screening with use of culturally targeted loss-framed messaging was especially pronounced for African American men.

What are some key implications of your findings for research, policy, or practice?

Our findings underscore the potential (and need!) to develop tailored health messaging for men and women. Better attending to gender differences may further enhance ongoing efforts to address racial health disparities through health communication and other behavioral interventions. Use of gender tailored messaging may be especially important for improving the health behavior of men, who very often lag women in their use of preventive tools, like cancer screening.

Where do you see this line of research heading in the future (i.e., what's next)?

We’ve observed a potentially important difference, but the next step is implementation in a real world context. Our team would very much like to use insights gleaned here to further design, implement and evaluate gender tailored versions of culturally targeted health communications in healthcare contexts that serve African American men and women.

Another direction is to further consider the “why” of this seemingly important gender difference. Our prior work suggested lower arousal of racism-related thinking as a mechanism that explains beneficial impacts of culturally targeted loss-framed messaging on African Americans. However, that pathway did not well explain the difference we saw between African American women and men. In future research, we’d also like to evaluate activation of masculinity-related thoughts and emotion as a potentially important mechanism to consider in designing effective gender tailored health communication.

How did you become interested in this line of inquiry?

Our team resides in midwestern cities that are predominantly African American, and that have long been challenged by cancer disparities (Detroit, Flint, and Milwaukee). There are many reasons for the disparities we see in our communities, including structural factors that must be addressed through broader social change. As behavioral scientists, our work stems from the desire to lessen the health impacts of inequitable investment in our communities over the years through ensuring effective use of recommended health behaviors. This includes aiding and partnering with African American men, who are frequently overlooked in designing and implementing behavioral health interventions.

Pictured left to right first author Todd Lucas and coauthors, Charles Rogers, Mark Manning, Olivia Aspiras, and Anurag Dawadi.