Breast Screening in Response to Gain, Loss, and Empowerment Framed Messages among Diverse, Low-Income Women Nathan S. Consedine, PhD David Horton, BA Carol Magai, PhD Rita Kukaka, DrPH, MA Abstract: Framed messaging has emerged as an important means of promoting a number of health behaviors, including breast cancer screening. However, studies of message framing have infrequently considered race and income as possible moderators of framing efects, despite their importance to screening behavior. he current study examined whether demographic characteristics moderated participant responses to message framing. In the study, 102 Black and 42 White low-income, low-screening women were randomized to a loss, gain, or empowerment frame telephone intervention and re-contacted at 6 and 12 months. Contrary to expectation, there was no main efect for framing condition, although both loss and empowerment conditions elicited superior screening than the gain condition at 12 months. Income proved an important moderator of framing efects, interacting with both condition and race to inluence screening. Message frames may difer in the amount of time they require to manifest in behavioral outcomes and may lead to changes in dif- ferent screening outcomes. Understanding how framing efects vary as a function of key demographic characteristics such as race and income is likely to prove important as such variables facilitate targeting of frames. Key words: Message framing, breast cancer screening, African American, low-income women, race diferences, ethnic diferences, mammogram, clinician breast exam, breast self-examination. R ecent estimates suggest that there will be 178,480 new cases of breast cancer diagnosed and 40,460 breast-cancer attributed deaths among women living in America in 2007. 1 While there is a lower incidence among African Americans than among White women, 2,3 mortality is higher, and 5-year survival lower, among minority women than among Whites; 3–5 furthermore, the mortality gap in breast cancer may be increasing. 6–8 Racial diferences in mortality and survival are frequently attributed Journal of Health Care for the Poor and Underserved 18 (2007): 550–566. PART I: ORIGINAL PAPER NATHAN CONSEDINE is Research Assistant Professor in the Psychology Department at Long Island University in Brooklyn (LIU), where he can be reached at 1 University Plaza, Brooklyn, NY 11201; (718) 780-4368; nconsedi@liu.edu. DAVID HORTON is ailiated with the Intercultural Institute on Human Development and Aging and CAROL MAGAI is in the Psychology Department, both at LIU. RITA KUKAFKA is ailiated with the Department of Biomedical Informatics Sociomedical Sciences (Public Health) at Columbia University.