Researcher Q & A: Researcher examines how message framing and emotions effect screening decisions

William Klein, PhD, is the Associate Director of the Behavioral Research Program at the National Cancer Institute. In the spring of 2007, as an assistant professor at the University of Pittsburgh, Dr. Klein received a grant from the Prevent Cancer Foundation. His research looked at how health messages are framed and the role of emotions in medical decision making. For example, are health messages more successful if they focus on the losses from not screening versus the gains from screening? Do emotions play a role in how people respond to different types of messaging? Dr. Klein shares his research findings and the impact of the Foundation’s funding early in his career.

What led you to the field of health communication and behavioral research?

My PhD is in social psychology, and I was doing a great deal of research on self-judgment, social comparison and optimism in the early part of my career which led me to think about how people judge risk and, by extension, how we can effectively communicate risk in ways that influence their health behavior in an adaptive way.

Tell us about your research on whether loss-framed messages will encourage more colorectal cancer screening, particularly in people who reflect on their future feelings. Did this effect occur because of their perceptions of vulnerability?

There was much work in previous research showing that loss-framed messages (e.g. if you don’t get screened you could have cancer and not know it) were more effective than gain-framed messages (e.g. if you get screened, you can reassure yourself that you don’t have cancer) in promoting screening. The reason is that people view screening as risky (because they could get bad news), and research in decision-making and behavioral economics shows that people are more likely to take risks when faced with a possible loss than with a possible gain. However, little work has been done on whether the emotions that people are experiencing at the time they get a message influence whether the message frame (loss vs. gain) makes a difference. So we decided to put people in an emotional state and then test how loss-framed or gain-framed messages affected them. We were pleased to find out that the gain-framed message was as effective as the loss-framed message at encouraging screening when people are in a positive emotional state, as caused by asking them to imagine the relief they would experience upon being told their test was negative. Without this “emotional booster,” however, the loss-framed message was more effective as has been shown in previous research.

How did receiving a Prevent Cancer Foundation grant impact your research?

I benefited a great deal from the opportunity to complete this project because it jump-started several other projects on how emotional experiences might have an impact on the effect of health communications on people’s risk perceptions and behavior. This study and others also showed me the value of supporting more-nuanced work in health communication, which I am now doing in my current position as Associate Director of the Behavioral Research Program at the National Cancer Institute.

Why is it important to fund research like this in cancer prevention and early detection?

It is important because many assumptions we make about communicating health risks are misguided. People’s goals, motivations and emotions are important factors in how they respond to health communications, so failing to recognize their influence may lead to failures to change behavior and may sometimes promote even riskier behavior. Funded research on effective strategies is essential.