Intention and affective responses to colorectal cancer screening messages among people who do and do not avoid colorectal cancer information

We conducted a preregistered experiment testing the comparative efficacy of five common communication strategies (fear, disgust, values affirmation/gain frame, disrupt-then-reframe, or self-efficacy) in people who do and do not avoid colorectal cancer (CRC) information. Participants (N = 274; 45–74 years, not CRC screening adherent, no history of CRC, 49% CRC information avoiders) were randomly assigned to view one of five brief CRC screening intervention videos or an attentional control video, after which they completed assessments of affect and screening intentions followed by manipulation checks. Participants who watched the fear, disgust, disrupt-then-reframe and self-efficacy videos, rather than the control video, had stronger intentions to talk to a doctor about screening and those who watched fear and self-efficacy videos had stronger intentions to be screened. Video effects on intentions did not vary between avoiders and nonavoiders, but affective responses did. Nonavoiders reported more positive affect if they viewed CRC videos rather than the control video, but the trend reversed for avoiders. There were indirect effects of avoidance on intentions through positive affect. Depressed positive affect in response to threatening information may be part of an avoidance affective signature that could undermine motivation to engage in health behaviors such as cancer screening.