TY - JOUR
T1 - The impact of redesigned advance notification letters on intention to screen for bowel cancer
T2 - a randomised controlled experiment
AU - Collins, Katelyn E.
AU - Ireland, Michael J.
AU - Myers, Larry S.
AU - Jenkins, Mark A.
AU - McIntosh, Jennifer G.
AU - Wilson, Carlene J.
AU - Taylor, Natalie
AU - Goodwin, Belinda C.
PY - 2025/6
Y1 - 2025/6
N2 - 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.
AB - 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.
KW - colorectal cancer screening
KW - colorectal neoplasms
KW - early detection
KW - faecal occult blood test
KW - prenotification
UR - http://www.scopus.com/inward/record.url?scp=105004703716&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/2010268
U2 - 10.1016/j.anzjph.2025.100246
DO - 10.1016/j.anzjph.2025.100246
M3 - Article
C2 - 40347580
AN - SCOPUS:105004703716
SN - 1326-0200
VL - 49
JO - Australian and New Zealand Journal of Public Health
JF - Australian and New Zealand Journal of Public Health
IS - 3
M1 - 100246
ER -
