Article Text

Original research
Application of the theory of regulatory fit to promote adherence to evidence-based breast cancer screening recommendations: experimental versus longitudinal evidence
  1. Serena Petrocchi1,
  2. Ramona Ludolph1,
  3. Nanon H M Labrie2,
  4. Peter Schulz1
  1. 1Institute of Communication & Health, Università della Svizzera italiana, Lugano, Switzerland
  2. 2Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Dr Serena Petrocchi; serena.petrocchi{at}


Objectives To reduce overtreatment caused by overuse of screening, it is advisable to reduce the demand for mammography screening outside the recommended guidelines among women who are not yet eligible for inclusion in systematic screening programmes. According to principles of regulatory fit theory, people make decisions motivated by either orientation to achieving and maximising gains or avoiding losses. A study developed in two phases investigated whether video messages, explaining the risks and benefits of mammography screening for those not yet eligible, are perceived as persuasive

Design Phase 1 was an experimental study in which women’s motivation orientation was experimentally induced and then they were exposed to a matching video message about mammography screening. A control group received a neutral stimulus. Phase 2 introduced a longitudinal component to study 1, adding a condition in which the messages did not match with the group’s motivation orientation. Participants’ natural motivation orientation was measured through a validated questionnaire

Participants 360 women participated in phase 1 and another 292 in phase 2. Participants’ age ranged from 30 to 45 years, and had no history of breast cancer or known BReast CAncer gene (BRCA) 1/2 mutation.

Results In phase 1, a match between participants’ motivation orientation and message content decreased the intention to seek mammography screening outside the recommended guidelines. Phase 2, however, did not show such an effect. Fear of breast cancer and risk perception were significantly related to intention to seek mammography screening

Conclusions Public health researchers should consider reducing the impact of negative emotions (ie, fear of breast cancer) and risk perception when promoting adherence to evidence-based breast cancer screening recommendations.

  • public health
  • Breast tumours
  • preventive medicine

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  • Contributors SP and RL drafted the first version of the manuscript. All authors contributed to writing and critically revising it and approved its final version. PS acquired funding. NHML, PS and RL designed study 1 and prepared the materials. PS, SP and RL designed study 2 and prepared the materials. SP and RL collected data for study 1. SP collected data for study 2. SP performed the analyses for study 1 and study 2.

  • Funding This work was supported by the Swiss National Science Foundation (grant number FNS 100019-153131/1).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The University’s Ethical Committee approved phase 1 and phase 2.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. Data are available on request.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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