Breast screening in response to gain, loss, and empowerment framed messages among diverse, low-income women

Framed messaging has emerged as an important means of promoting a number of health behaviors, including breast cancer screening. However, studies of message framing have infrequently considered race and income as possible moderators of framing effects, despite their importance to screening behavior. The current study examined whether demographic characteristics moderated participant responses to message framing. In the study, 102 Black and 42 White low-income, low-screening women were randomized to a loss, gain, or empowerment frame telephone intervention and re-contacted at 6 and 12 months. Contrary to expectation, there was no main effect for framing condition, although both loss and empowerment conditions elicited superior screening than the gain condition at 12 months. Income proved an important moderator of framing effects, interacting with both condition and race to influence screening. Message frames may differ in the amount of time they require to manifest in behavioral outcomes and may lead to changes in different screening outcomes. Understanding how framing effects vary as a function of key demographic characteristics such as race and income is likely to prove important as such variables facilitate targeting of frames.