The impact of redesigned advance notification letters on intention to screen for bowel cancer: a randomised controlled experiment

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health Pub Date : 2025-05-09 DOI:10.1016/j.anzjph.2025.100246

Katelyn E. Collins , Michael J. Ireland , Larry S. Myers , Mark A. Jenkins , Jennifer G. McIntosh , Carlene J. Wilson , Natalie Taylor , Belinda C. Goodwin

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引用次数: 0

Abstract

Objectives

The aim of this study was to examine the impact of redesigned advance notification letters on screening intention and the moderating role of screening barriers/facilitators.

Methods

In an online survey, 562 Australians aged 50–74 years were randomised to view one of three letters: the current letter (control) or one of two redesigns with enhanced graphics and evidence-based messaging. Participants rated their screening intention before and after viewing, with screening barriers and facilitators also measured.

Results

The redesigned letters did not increase screening intention over the control [control vs. Redesign 1: the estimated effect of the predictors (b)=0.12, p=0.204; control vs. Redesign 2: b=0.07, p=0.471]. Higher self-efficacy (b=0.12, p<0.001), perceived benefits (b=0.12, p<0.001), lower autonomy concerns (b=−0.23, p<0.001), avoidance (b=−0.16, p=0.004), disgust (b=−0.12, p=0.011) and perceived difficulty (b=−0.02, p<0.001) moderated the letters’ effect on intention for all letter versions.

Conclusions

Advance notification letters increase intention, with certain reactions (e.g. high self-efficacy and perceived benefits) enhancing this effect. Design and content changes may not improve impact beyond the letter’s intrinsic effect.

Implications for Public Health

Multi-pronged approaches may better address individual barriers. Exploring digital formats may enhance advanced notification effects.

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重新设计的提前通知信对肠癌筛查意向的影响：一项随机对照实验

目的探讨重新设计的提前通知信对筛查意向的影响，以及筛查障碍/促进因素的调节作用。方法在一项在线调查中，562名年龄在50-74岁之间的澳大利亚人被随机分配观看三种信件中的一种：当前信件（对照）或两种重新设计的信件（增强图形和循证信息）中的一种。参与者在观看之前和之后评估了他们的观看意图，也测量了观看障碍和促进者。结果重新设计的字母没有比对照增加筛查意愿[对照与重新设计1：预测因子的估计效果(b)=0.12, p=0.204；对照组vs.重新设计2:b=0.07, p=0.471]。较高的自我效能（b=0.12, p<0.001）、感知到的利益（b=0.12, p<0.001）、较低的自主性关注（b= - 0.23, p<0.001）、回避（b= - 0.16, p=0.004）、厌恶（b= - 0.12, p=0.011）和感知到的困难（b= - 0.02, p<0.001）调节了字母对所有字母版本意图的影响。结论提前通知信增加了意向，某些反应（如高自我效能和感知利益）增强了这种作用。设计和内容的改变可能不会提高信件的内在效果之外的影响。对公共卫生的影响多管齐下的方法可能更好地解决个人障碍。探索数字格式可以增强高级通知效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australian and New Zealand Journal of Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.20

自引率

5.70%

发文量

121

审稿时长

6-12 weeks

期刊介绍： The Australian and New Zealand Journal of Public Health (ANZJPH) is concerned with public health issues. The research reported includes formal epidemiological inquiries into the correlates and causes of diseases and health-related behaviour, analyses of public policy affecting health and disease, and detailed studies of the cultures and social structures within which health and illness exist. The Journal is multidisciplinary and aims to publish methodologically sound research from any of the academic disciplines that constitute public health.