Psychological Traits and the Persuasiveness of Lung Cancer Screening Health Messages.

BACKGROUND: Lung cancer screening remains underused despite its proven mortality benefit. Health systems have attempted to increase screening awareness through advertising. Psychological theories suggest that construal level (a personal orientation toward the big picture or the details) and regulatory focus (goals emphasizing acquisition of a good or avoidance of a bad outcome) play a key role in health advertising effectiveness. These theories have not been examined in a screen-eligible population. METHODS: Using Amazon's crowdsourcing platform, Mechanical Turk, we identified screen-eligible individuals based on US Preventive Services Task Force criteria. We randomly assigned participants to see 1 of 4 screening advertisement images in a 2 (construal level: high vs low) × 2 (regulatory focus: promotion vs prevention) between-subjects experimental design. We assessed willingness to undergo screening after the advertisement. RESULTS: One hundred ninety-one individuals responded to our study invitation (mean age, 61 years). We found that the high construal/promotion focus image led to a greater willingness to screen compared with images representing other psychological states (P = .04). Regarding the personality traits of our respondents, high construal/promotion focus was the most prevalent (40%) trait combination, whereas low construal/prevention focus was the least prevalent (17%). CONCLUSIONS: The psychological focus of health-related messages affects an individual's willingness to undergo lung cancer screening. Individuals eligible for lung cancer screening are more persuaded by "big picture" messages describing the benefits of screening. Health systems may use this knowledge to design more effective patient-facing communications that lead to higher rates of screening.

Evaluating Knowledge, Attitudes, and Beliefs About Lung Cancer Screening Using Crowdsourcing.

BACKGROUND: Lung cancer screening, despite its proven mortality benefit, remains vastly underutilized. Previous studies examined knowledge, attitudes, and beliefs to better understand the reasons underlying the low screening rates. These investigations may have limited generalizability because of traditional participant recruitment strategies and examining only subpopulations eligible for screening. The current study used crowdsourcing to recruit a broader population to assess these factors in a potentially more general population. METHODS: A 31-item survey was developed to assess knowledge, attitudes, and beliefs regarding screening among individuals considered high risk for lung cancer by the United States Preventive Services Task Force. Amazon's crowdsourcing platform (Mechanical Turk) was used to recruit subjects. RESULTS: Among the 240 respondents who qualified for the study, 106 (44%) reported knowledge of a screening test for lung cancer. However, only 36 (35%) correctly identified low-dose CT scanning as the appropriate test. A total of 222 respondents (93%) reported believing that early detection of lung cancer has the potential to save lives, and 165 (69%) were willing to undergo lung cancer screening if it was recommended by their physician. Multivariable regression analysis found that knowledge of lung cancer screening, smoking status, chronic pulmonary disease, and belief in the efficacy of early detection of lung cancer were associated with willingness to screen. CONCLUSIONS: Although a minority of individuals at high risk for lung cancer are aware of screening, the majority believe that early detection saves lives and would pursue screening if recommended by their primary care physician. Health systems may increase screening rates by improving patient and physician awareness of lung cancer screening.

Opioid Use Following Bariatric Surgery: Results of a Prospective Survey.

BACKGROUND: Opioid use after bariatric surgery is not clearly understood. Few guidelines exist to inform opioid-prescribing practices after bariatric surgery. OBJECTIVE: To understand opioid use following bariatric surgery. SETTING: University hospital. METHODS: Bariatric surgery patients at a single center were prospectively surveyed at the time of their post-operative visit (January-May 2018). Patients were asked about their opioid use following surgery, whether they received education about opioid use and what they did with leftover medications. Demographic and operative details were obtained from the medical record. RESULTS: Among 33 patients, the majority (n = 29, 88%) were female with a median age of 40 (20-68) and body mass index of 44.8 (33-78.5). Most patients had leftover narcotics (n = 25, 73%). The median number of pills used was 15 (0-48). Only 12 patients (36%) thought that they had been prescribed "too much" pain medication. Most patients reported receiving education about expectations for post-operative pain (n = 22, 69%); few recalled education about reducing or stopping opioids (n = 13, 40%). More than half of patients (n = 17, 53%) kept their leftover opioids rather than disposing of them or bringing them to an approved turn in location. CONCLUSIONS: Despite most patients having leftover opioids following surgery, few patients recognized possible overprescription. Education regarding opioid use following surgery is inconsistent, potentially contributing to the amount of retained opioids currently available. Future guidelines should focus on determining the appropriate amount of opioids to be prescribed following surgery and standardizing and improving education given to patients.