Empowering Women to Promote Prostate Cancer Screening: Effects of Message Framing in Brochures

Abstract

Background: Prostate cancer is a leading cause of cancer mortality among men globally as well as in Kenya. Successful detection, treatment, and management of prostate cancer are dependent on emotional, social, physical, and financial support. Female partners have been shown to motivate, counsel, and enhance their self-esteem. Therefore, the present study aimed to assess the effect of gain-framed and loss-framed brochure interventions on knowledge and recommendations for prostate cancer screening among female partners.

Material and Methods: The study adopted a randomized controlled trial design, whereby the control and the two intervention sites were randomly selected from a sampling frame of the sub-counties in Kiambu County. At the control and intervention sites, female partners of men above the age of 40 years who were the study participants were randomly selected. Intervention involved the use of gain-framed and loss-framed brochures. The sample size was determined using Magnani formulae, and 279 respondents from the control and intervention sites were recruited into the study. The chi-square test was used to assess differences in recommendations for prostate cancer screening, general knowledge of prostate cancer, knowledge of signs of prostate cancer (PC), and prostate cancer screening (PCS) methods between the control and intervention groups at baseline and end line. Further, data were subjected to structural equation modeling to assess the influence of knowledge on recommendations for prostate cancer screening.

Results: there was a significant difference in female partner recommendations for prostate cancer screening among male partners in the control and intervention groups (χ2 =14.591, p= 0.001). Both intervention groups (gain- and loss-framed) had dramatically higher recommendation rates compared to the control group. The difference between gain-framed (93.4%) and loss-framed (91.2%) was relatively small, and the two approaches were highly effective, nearly doubling the recommendation rate compared with the control group. The gain- and loss-framed brochure intervention significantly improved general knowledge on PC, knowledge of PC signs, and knowledge of PCS compared to the control group. Improvements from zero baseline knowledge of PC screening methods are particularly noteworthy. Gain-framed messaging was most effective for general knowledge of PCS methods, which increased by 63% and 31.9%, respectively, while loss-framed messaging was more effective in increasing knowledge of PC signs by 27.4%.

Conclusion: The study therefore recommends the need for partners in health to ensure provision of hybrid educational materials using both gain- and loss-framed approaches in healthcare settings, as well as ensuring education for both female and male about prostate cancer.