Testing whether barriers to a hypothetical screening test affect unrelated perceived benefits and vice versa: A randomised, experimental study.
Determine whether (fictitious) health screening test benefits affect perceptions of (unrelated) barriers, and barriers affect perceptions of benefits.



UK adults were recruited via an online survey panel and randomised to receive a vignette describing a hypothetical screening test with either high or low benefits (higher vs. lower mortality reduction) and high or low barriers (severe vs. mild side-effects; a 2×2 factorial design). ANOVAs compared mean perceived benefits and barriers scores. Screening 'intentions' were compared using Pearson's χ2test.



Benefits were rated less favourably when barriers were high (mean: 27.4, standard deviation: 5.3) than when they were low (M: 28.5, SD: 4.8; p=0.010, partial η2=0.031). Barriers were rated more negatively when benefits were low (M: 17.1, SD: 7.6) than when they were high (M: 15.7, SD: 7.3; p=0.023, partial η2=0.024). Most intended to have the test in all conditions (73-81%); except for the low benefit-high barrier condition (37%; p<0.0005; N=218).



Perceptions of test attributes may be influenced by unrelated characteristics.



Reducing screening test barriers alone may have suboptimal effects on perceptions of barriers if benefits remain low; increasing screening benefits may not improve perceptions of benefits if barriers remain high.
Department of Epidemiology and Public Health, University College London, London, UK.
Alex
A
Ghanouni
Department of Epidemiology and Public Health, University College London, London, UK.
Ella
E
Nuttall
Department of Epidemiology and Public Health, University College London, London, UK.
Jane
J
Wardle
Department of Epidemiology and Public Health, University College London, London, UK. Electronic address: c.wagner@ucl.ac.uk.
Christian
C
von Wagner
D000328:Adult; D000368:Aged; D003142:Communication; D003657:Decision Making; D005260:Female; D040261:Harm Reduction; D006801:Humans; D033182:Intention; D008297:Male; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D010465:Perception; D011315:Preventive Medicine; D011634:Public Health; D012306:Risk
Affect; Cognitive biases; Decision making; Emotion; Preventive medicine; Public health; Risk communication; Risk perception; Screening; Survey methods
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