The Effect of Message Framing and Screening Bundling on Preventive Screening Engagement: A Randomized Field Experiment

The investigators will conduct a randomized controlled trial in the domain of preventive care engagement. Participants with two exams pending (a cancer screening test and a chronic disease test for diabetes and dyslipidemia) will be randomly assigned to a 3 × 3 factorial design. The first factor manipulates message framing, randomly assigning participants to receive either (i) a standard Whatsapp message, (ii) a Whatsapp message emphasizing age-related health risks and the importance of early detection, or (iii) a message emphasizing the potential peace of mind associated with completing screening. The second factor manipulates the type of exam highlighted in the outreach, randomly assigning participants to receive outreach focused on (i) cancer screening only, (ii) chronic disease testing only, or (iii) both cancer screening and chronic disease testing. Patients who have only one pending cancer exam are randomly assigned across the three message framing conditions only and are encouraged to get the cancer screening.

The experiment will test two sets of research questions.

Question 1. How does emphasizing different motivations for completing cancer screening affect patient engagement?

H1a. This study will test how messages emphasizing age-based health risks and the importance of early detection affect cancer screening engagement, relative to a basic message. Emphasizing health risks may increase perceived urgency and boost engagement; however, prior work on information avoidance suggests this framing may instead prompt avoidance of screening-related information and reduce engagement.

H1b. This study will test whether messages emphasizing that completing screening can bring peace of mind increase engagement relative to a basic message.