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基于信息框架的宫颈癌科普干预对妇科门诊患者筛查偏好影响

Impact of a message framing-based cervical cancer science popularization intervention on screening preferences of gynecologic outpatients

  • 摘要:
    目的 利用信息框架效应,研究正、负向宫颈癌筛查科普信息对妇科门诊患者筛查偏好的影响,为提升科普效能以及改善高风险人群的健康筛查行为提供参考依据。
    方法 于2023年8月—2024年3月,以上海市闵行区4所医院妇科门诊患者为研究对象,基于信息框架设计宫颈癌筛查科普正向、负向信息组,研究对象被随机分配至不同信息组接受信息干预,通过离散选择实验调查研究对象的选择偏好,最终正向、负向信息组分别纳入221、227例患者,应用STATA 16.0软件混合logit模型进行偏好分析。
    结果 妇科患者普遍对公立医院、女医生、更短筛查时间间隔以及更低漏诊率、误诊率属性水平具有正向偏好(β>0)。但不同信息组的研究对象对于属性的重视程度与支付意愿有较大差异,在正向信息组中相对重要性最高的为筛查地点(25.08%),最低为筛查时间间隔(7.24%);负向信息组中相对重要性最高的为误诊率(22.41%),最低为疼痛感(10.96%)。2组比较,正向信息组对于公立医院、无疼痛感、女医生的支付意愿更高;负向信息组对于5%漏诊率、5%误诊率、筛查时间间隔1年以及2年的支付意愿更高。
    结论 正向、负向信息对研究对象宫颈癌筛查偏好产生影响,其中负向信息组的研究对象更关注筛查结果,倾向于为高频、高准确率的筛查方案支付更高费用;而正向信息组的研究对象则更注重筛查过程,并愿意为筛查的舒适体验支付更高费用,科普信息干预应差异化实施。

     

    Abstract:
    Objective To investigate the impact of positive and negative cervical cancer screening science messages on screening preferences of gynecologic outpatients by using message framing effects to inform decision making to enhance science popularization efficacy as well as improve health screening behaviors of high-risk populations.
    Methods From August 2023 to March 2024, we conducted discrete choice experiments with gynecologic outpatients from four hospitals in Minhang district of Shanghai. Participants were randomly assigned to either positive or negative massage intervention groups, with 221 participants in the positive group and 227 participants in the negative group ultimately included. The mixed logit model in STATA 16.0 was used for data analysis.
    Results Both groups demonstrated positive preferences (β > 0) for public hospitals, female physicians, shorter screening intervals, and lower false-negative/positive rates. However, attribute prioritization and willingness-to-pay (WTP) differed substantially between groups: the positive group prioritized screening location (25.08%) over time interval (7.24%), while the negative group emphasized false-positive rate (22.41%) over pain perception (10.96%). Comparative analysis revealed higher WTP in the positive group for public hospitals, painless procedures, and female physicians, whereas the negative group showed greater WTP for annual screening, biennial screening, and protocols with 5% false-negative/positive rates.
    Conclusions Message framing significantly impacts screening preferences, with negative framing emphasizing result accuracy and screening frequency, versus positive framing prioritizing procedural comfort. These findings advocate for differentiated science popularization strategies in health promotion campaigns.

     

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