1. Tested Messages to Reach the Unscreened 80% by 2018 Forum Mary Doroshenk, MA, NCCRT Director 1

2. Objectives and Methodology In an effort to better understand the barriers that prevent screening of colon cancer as well as the disconnect of healthcare feedback and patient actions, the following research was conducted: – An online study among 1,023 U.S. adults 50 years of age or older in early March, 2014. – An online study among 403 primary care physicians in early April, 2014. – In-depth interviews conducted among 15 consumers (45 minutes long; 5 among Black/African American, 5 among White respondents and 5 among Hispanic respondents) and 10 physicians (30 minutes long) in April – June, 2014. – A roundtable discussion with leaders from Community Health Centers. – Message testing among 1,068 unscreened adults 50 years of age or older in October, 2014. Specific objectives of the research are to measure and probe: – Awareness of screening methods – Completion of colorectal screening – Rationale for being screened/not being screened – Identification of drivers to change behaviors and channels to communicate Tested messages for the unscreened 2

3. Barriers to Screening 3 Unscreened have lower income than screened counterparts More likely to be uninsured Newly insured don’t know it’s covered Affordability Symptoms drive doctor visits Misconception about disease Lack of symptoms Perception that heredity is only risk factor Reduced sense of urgency No family history Focus on acute illnesses and issues of more concern Not a top priority No personal connection to cancer More pressing health issues Connotation of test being unpleasant, invasive, embarrassing Fear of test-prep compounds negativity Negative perceptions about the test Utilize medical neighborhood Avoids doctors/no routine physicals or wellness visits Think they’re healthy already No regular primary care to reinforce message #1 reason among African Americans #3 reason among Hispanics Doctor does not recommend it

4. 4 Logical and rational messages about the benefits of screening will likely be insufficient to move the unscreened base. SCREENED UNSCREENED Recommended by my doctor It is a way for me to be proactive about my health Screening can prevent cancer Recommended for my age Screening now covered by most insurers by law Recommended by top health orgs. Consumers: Likelihood* to Get CRC Test if Knew Each of The Following * Reference to likelihood = 8-10 rating on a 10 point scale where 1 means, “Not at all likely” and 10 means, “Extremely likely” * 45% of unscreened give a low-medium rating for ALL statements Messages that will resonate the best should address misperceptions and fears around the test, feature testimonies from those who have been screened all while adapting messages to tap into consumers’ emotional motivations for making health decisions.

5. 5 Newly insuredInsured procrastinator/rationalizerFinancially challenged Hispanic (53% screening rate) Caucasian African American Asian American/Pacific Islander Native American/Alaska Native Hispanic (53% screening rate) Caucasian African American Asian American/Pacific Islander Native American/Alaska Native Key Targets

6. Activating Messages that Motivate There are several screening options available, including simple take home options. Talk to your doctor about getting screened. Colon cancer is the second leading cause of cancer deaths in the U.S., when men and women are combined, yet it can be prevented or detected at an early stage. Preventing colon cancer, or finding it early, doesn’t have to be expensive. There are simple, affordable tests available. Get screened! Call your doctor today. Most successful communications campaigns relay three messages to allow consumers to comprehend what is being asked to motivate action. We would recommend utilizing these messages, or similar messaging to educate your constituents around options to help us achieve our goal of reaching the 80% screening rate by 2018.

7. Moving Consumers to Action 7 http://nccrt.org/tools/80-percent-by-2018/80-by-2018-communications-guidebook/ 2015 Communications Guidebook

8. Fight Colorectal Cancer

9. GW Cancer Institute Social Media Toolkits target specific awareness months Explains social media basics and provides a mini-tutorial on media management and evaluation Provides sample Facebook posts and Tweets to use MonthTopic October 2014Breast Cancer November 2014Lung Cancer January 2015Cervical Cancer/HPV February 2015World Cancer Day March 2015Colorectal Cancer September 2015Prostate Cancer Social Media Toolkits

10. Health Care Service Corporation (HCSC) “How can we reach the unscreened in a more strategic way?” -Utilize toolkit to identify best messages to inform health plans’ colorectal cancer strategies -Co-Branded Reminders & Messaging Development

11. Next Steps Developing tested messages for Spanish speaking audience Update Communications Guidebook for March 2016 Design and share messaging strategy for March 2016 Roll out Achievement Awards program to recognize 80% by 2018 successes

12. Resources NCCRT information and materials www.nccrt.org/tools http://nccrt.org/tools/80-percent-by-2018/ Thank you!!! mdoroshenk@cancer.org