The Influence of Message Framing on Adolescent Females\u27 Intention to Obtain Chlamydia Screening

Purpose: Literature has suggested that loss-framed messages may be better at promoting disease detection behaviors, whereas gain-framed messages may be more successful at promoting prevention behaviors. This study evaluated the effect of message frame on intention to obtain Chlamydia screening among adolescent females. Methods: Study Design: Participants were randomly assigned to receive a gain-framed or loss-framed brochure. The gain-framed brochure emphasized the advantages of screening whereas the loss-framed brochure emphasized the disadvantages of not getting screened. Participants: 100 young women, ages 15 to 19, were recruited from an adolescent clinic and three community based organizations in a small, New England city. Interventions: Participants were randomly assigned to read either a gain-framed or loss-framed brochure. Each brochure included a section devoted to the framing manipulation as well as non-framed information about Chlamydia, its complications, and how to get screened. Surveys: Participants completed pre- and post-intervention surveys measuring knowledge about Chlamydia, attitudes about screening, subjective risk assessment, and intention to obtain Chlamydia screening. The post-intervention survey also assessed participants’ attitude to the message, risk factors for Chlamydia, and included a manipulation check. Outcome measures included change in level of intention to obtain Chlamydia screening and change in knowledge and attitude towards screening. Analyses: Analyses included frequency distributions and mean responses. Chi-square and paired and unpaired t-tests were used to compare groups. Results: Mean age was 17.0 (SD=1.3). Participants were 23% Hispanic, 63% white, and 14% African American. Knowledge scores significantly improved from pre- to post-intervention (p\u3c0.01). Improvement was not associated with message frame (r=0.00, p=0.99). Among the 60 sexually active participants, there was no significant difference in feelings or attitudes about being tested between the two framing manipulations. After reading the brochure, 15 of the 35 (43%) sexually active participants who were not already receiving routine Chlamydia screening had a greater intention to obtain screening. Intent to obtain screening was not associated with framing condition (X2=0.24, p=0.63). Conclusion: This preliminary data suggests that message framing does not influence adolescent females’ intention to obtain Chlamydia screening. However, after reading either brochure, participants were significantly more likely to demonstrate improved knowledge about Chlamydia and a substantial proportion had more intention to obtain screening, suggesting that similar brochures may be an effective method of communicating information about Chlamydia and motivating teens to obtain screening. Sources of support: Commonwealth Medicine Mini Grant and NIH 1 K23 AI01750. Research poster presentation at the Society for Adolescent Medicine Annual Meeting