Interventions to Decrease Cancer Information Avoidance

ABSTRACT Health information avoidance is an overlooked threat to the reach and effectiveness of health communication. For a given health threat, 20%-30% of the general population tends to avoid initiating information seeking or avoid exposure to information. To fully realize the benefits of our sizeable investments in health messaging, we need to identify strategies for reducing health information avoidance. We will develop and test a video- based strategy for reducing defensive colorectal cancer information avoidance. Colorectal cancer is a suitable domain for developing the intervention as it is the fourth most common and second deadliest cancer in the United States, but also one of the most preventable with screening and lifestyle change. Health communication that reaches people who otherwise avoid colorectal cancer information (about 20% of the population), has the potential to improve screening rates. The research is grounded in a theoretically and empirically based conceptual model of defensive health information avoidance in which three key beliefs associated with agency – greater self-efficacy, perceived resources, and perceived control – are hypothesized to reduce avoidance. Specific Aim 1 is to identify which of 3 brief video interventions targeting self-efficacy, perceived resources or perceived control singly or in combination with each other, reduces colorectal cancer health information avoidance the most. Participants will be 714 individuals who avoid colorectal cancer information and 714 who do not, recruited from NORC''s nationally representative AmeriSpeak panel. Intervention(s) that produce lower colorectal cancer information avoidance compared to a no video control condition will be retained and if more than one intervention is efficacious, they will be combined. In Specific Aim 2, we will test whether the most effective intervention video (or combination of videos) from Aim 1 reduces health information avoidance in a real-world mass communication setting. Participants (N 0) will be social media users aged 40-75 years, recruited from Facebook. In Specific Aim 3, we will test whether combining the Aim 1 avoidance reduction intervention video with a screening reminder message increases requests for screening referrals and colorectal cancer screening in a real-world clinic setting. Participants (N 0) will be aged 45-75 years and not adherent to colorectal cancer screening guidelines. They will be recruited from primary care practices that serve economically and racially diverse patients. The intervention will be mHealth ready and could be disseminated in conjunction with social media and other mass media health messaging campaigns, via patient portals or physician offices. The intervention strategy would be generalizable beyond colorectal cancer control because health information avoidance is common across a range of diseases and