Dr. Samanthika Ekanayake1 Dr. Diego Llovet1 Dr. Jorge Ginieniewicz1 Dr. Lawrence Paszat1, 2
1Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto 2 Institute for Clinical Evaluative Sciences
© Dr. Samanthika Ekanayake 2014
“I appreciate it was a human being giving me information”: Use of a testimonial to promote colorectal cancer screening with fecal occult blood test
Cancer Care Ontario. ColonCancerCheck 2010 Program Report. Toronto, Canada
2012.
Dal Cin S, Zanna MP, Fong GT. Narrative persuasion and overcoming resistance. In:
Knowles ES, Linn JA, editors. Resistance and persuasion. Mahwah, NJ: Lawrence
Erlbaum Associates; 2004. p. 175–91.
Dillard AJ1, Fagerlin A, Dal Cin S, Zikmund-Fisher BJ, Ubel PA. (2010) Narratives that
address affective forecasting errors reduce perceived barriers to colorectal cancer
screening. Soc Sci Med. 71(1):45-52.
Kreuter,M.W.,Green,M.C.,Cappella,J.N.,Slater,M.D.,Wise,M.E.,Storey,D.,etal
(2007).Narrative communication in cancer prevention and control: a frame-work to
guide research and application. Annals of Behavioral Medicine,33, 221-235.
Rabeneck L, Tinmouth JM, Paszat LF, Baxter NN, Marrett LD, Ruco A, Lewis N, Gao
J. (2014) Cancer Ontario's ColonCancerCheck: results from Canada’s first province-
wide colorectal cancer screening program. Epidemiol Biomarkers Prev. 23(3):508-15.
Tinmouth J, Ritvo P, McGregor SE, Claus D, Pasut G, Myers RE, et al. (2011) A
qualitative evaluation of strategies to increase colorectal cancer screening uptake.
Can Fam Physician. 57:7-15.
Contact Information: [email protected]
• Testimonials from people who had a good
experience with FOBT may create a positive frame
of mind towards screening among some eligible
individuals.
• Peer testimonials can be used to persuasively
convey key facts and arguments about colorectal
cancer screening.
• Testimonials may be considered for inclusion in
communication campaigns promoting screening
with FOBT.
• Testimonials may be more effective if signed by
someone with a gender-neutral name; the
testimonial should appear clearly separated from
the main text of the letter.
• Peer testimonials are first-person narrative
messages that convey an experience to similar
others.
• Narratives influence readers’ emotions and
beliefs, and may be effective in promoting specific
health behaviour (Dal Cin et al., 2004).
• Narrative communication is more effective in
convincing or influencing people with limited
experience or knowledge of screening (Kreuter et
al., 2007).
• People find it difficult to counterargue or deny
narratives because they are associated with real-
life characters and experiences (Dal Cin et al.,
2004).
• Narratives from peers are an effective way to
promote CRC screening (Dillard et al., 2010).
• Colorectal cancer (CRC): second-leading cause of
cancer deaths and third most commonly
diagnosed cancer in Ontario (Cancer Care
Ontario, 2012).
• ColonCancerCheck, the provincial CRC screening
program, recommends bi-annual screening with
Fecal Occult Blood Test (FOBT) for average risk
individuals aged 50 to 74 (CCO, 2012).
• Mailed letters are used to invite eligible people to
do FOBT; however, FOBT participation rate in
Ontario remains low; only 30% of the eligible
population completed the test in 2010-2011
(Rabeneck et al., 2014).
• Previous studies have suggested that brief and
personalized letters with strong and powerful
messages would be helpful to increase screening
uptake (Tinmouth et al., 2011).
• Seven focus groups in Barrie, Scarborough,
Guelph and Hamilton in 2013 to test messages
for FOBT promotion.
• 52 participants were recruited through random
digit-dialling.
• Participants: aged 50-74, 40% female, 54%
Canadian-born, 30% high-school graduates or
lower, 30% never-screened for colorectal
cancer. Separate male and female groups were
conducted.
• Phase 1 (4 focus groups, Winter): Participants
were shown a testimonial of positive FOBT
experience from a peer living in the same area
and of the same gender as them.
• •
• Participants were asked whether testimonial
was clear, believable, acceptable and
compelling.
• Phase 2 (3 focus groups, Summer): Participants
were shown FOBT invitation letters that
included a peer testimonial; initial testimonial
was slightly changed based on the findings of
the initial focus groups.
• Focus groups were audio-recorded, transcribed
verbatim and analyzed using Nvivo10.
• Focus group findings from phases one and two
are presented below.
• The testimonial was well-received by most of
the participants. The “human feeling” and the
“personal tone” of the message made it credible
and reassuring to many.
• Several participants appreciated hearing
about the screening experience from “someone
like them.”
• Many participants liked the testimonial because
it gives a “positive” feeling or “sense of comfort.”
Having peace of mind after receiving normal
FOBT results was seen as important. The
message also reinforced how easy FOBT is.
• A few participants disliked the testimonial,
saying that it may not be personally relevant to
them. They felt the testimonial was “gimmicky”
and may not be real. Others preferred "factual"
over "anecdotal" messages.
• Based on the results of this study, the initial
testimonial was modified and the following
testimonial was used in new invitation letters:
“Doing the FOBT was easy and I knew within a few
weeks that my result was normal. I am thankful for
the peace of mind!”
(Terry K., Guelph)
• This study explores how individuals eligible for
FOBT screening react to a written testimonial of
someone sharing his/her positive FOBT
experience.
"I completed the FOBT
and I knew within a few
weeks that everything
was fine. I am thankful
for the peace of mind.”
(Margaret S, Barrie)
Background
Use of Testimonials in Screening
Promotional Materials
Objectives
Methodology
Results
Conclusions and Recommendations
“I appreciated that it was a human being who was
giving me information…. [the testimonial] is easy-
going. It’s less formal…So that would be okay. That
would probably put me at ease if, because this
circumstance is all a little bit, unnerving to begin with,
to think that you needed to be screened to begin
with.” (Paula, Guelph)
“…There’s a face to this Peter S. He is one of us, and
he of course is expressing his sincere kind of, you
know, thanks or what that he did it…I like [this
message].” (Phillip, Scarborough)
“...if someone else has done it and it was that easy and
it’s given them peace of mind, yeah, it’s probably a lot
easier than you think it’s going to be … it’s just
reinforcing the fact that you’re kind of in control so why
not just do it. Why not just do it.” (Bonnie, Hamilton)
“It’s a testimonial. It’s one person who’s done it. Word of
mouth…word of mouth usually helps people…to think.
Like, if you had a good experience and somebody else
had a good experience and this is why I think
encouraging people to talk about issues of prostate
cancer, colon cancer, other things… the initial
experience from somebody else, I think, has a positive.”
(Josie, Scarborough)
“I don't need it at all. Maybe I've read too many
commercial …junk mail… It’s not important to me. I
don't know whether it's (peer testimonial) true or you
added it, or whether you exaggerated it, or what.”
(Dominic, Scarborough)
References
Top Related