Message framing to inform cancer prevention pricing interventions in the UK and USA: a factorial experiment, 2019

Lee, J. G.L., Cristello, J. V., Buckton, C. H. , Carey, R. N., Trucco, E. M., Schenk, P. M., Ikegwuonu, T., Hilton, S. , Golden, S. D. and Conway, D. I. (2021) Message framing to inform cancer prevention pricing interventions in the UK and USA: a factorial experiment, 2019. BMJ Open, 11(1), e041324. (doi: 10.1136/bmjopen-2020-041324) (PMID:33495253) (PMCID:PMC7839858)

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Abstract

Objectives: To advance understanding of how message framing can be used to maximise public support across different pricing policies for alcohol, tobacco and sugary drinks/foods that prevent consumption of cancer-causing products. Design: We designed a 3×4×3 randomised factorial experiment to test responses to messages with three pricing policies, four message frames and three products. Setting: Online survey panel (Qualtrics) in 2019. Participants: Adults (N=1850) from the UK and USA. Interventions: Participants randomly viewed one of 36 separate messages that varied by pricing policy (increasing taxes, getting rid of price discounts, getting rid of low-cost products), four frames and product (alcohol, tobacco, sugary drinks/foods). Primary and secondary outcome measures: We assessed the relationship between the message characteristics and four dependent variables. Three were related to policy support: (1) increasing taxes on the product mentioned in the message, (2) getting rid of price discounts and special offers on the product mentioned in the message and (3) getting rid of low-cost versions of the product mentioned in the message. One was related to reactance, a psychological response to having one’s freedom limited. Results: We found no effect for pricing policy in the message. Frames regarding children and reducing cancer risk moderated some outcomes, showing promise for real-world use. We found differences in support by product and reactance with greatest support and least reactance for tobacco policies, less support and more reactance for alcohol policies, and the least support and most reactance for sugary drinks/foods policies. Conclusions: Cancer prevention efforts using policy interventions can be informed by the message framing literature. Our results offer insights for cancer prevention advocacy efforts across the UK and USA and highlight that tax versus non-tax approaches to increasing the cost of cancer-causing products result in similar responses from consumers.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Ikegwuonu, Dr Theresa and Hilton, Professor Shona and Buckton, Christina and Conway, Professor David
Authors: Lee, J. G.L., Cristello, J. V., Buckton, C. H., Carey, R. N., Trucco, E. M., Schenk, P. M., Ikegwuonu, T., Hilton, S., Golden, S. D., and Conway, D. I.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN:2044-6055
ISSN (Online):2044-6055
Published Online:25 January 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in BMJ Open 11(1): e041324
Publisher Policy:Reproduced under a Creative Commons License
Data DOI:10.15139/S3/IAKUQN

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
727651SPHSU Core Renewal: Measuring and Analysing Socioeconomic Inequalities in Health Research ProgrammeAlastair LeylandMedical Research Council (MRC)MC_UU_12017/13IHW - MRC/CSO SPHU
Chief Scientist Office (CSO)SPHSU13
727671SPHSU Core Renewal: Informing Healthy Public Policy Research ProgrammePeter CraigMedical Research Council (MRC)MC_UU_12017/15IHW - MRC/CSO SPHU
Chief Scientist Office (CSO)SPHSU15
300966Advancing Cancer Prevention Pricing Interventions Across the US and UK: Optimising Message FramingDavid ConwayCancer Research UK (CRUK)C18486/A25644Med - Dental School