Does Messaging for Reducing Breast Cancer Overscreening in Older Women Have Differential Responses among Medical Minimizers and Maximizers?

Nancy L. Schoenborn, Sarah E. Gollust, Rebekah H. Nagler, Mara A. Schonberg, Cynthia M. Boyd, Qian-Li Xue, Yaldah M. Nader and Craig E. Pollack
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Nancy L. Schoenborn: Johns Hopkins University School of Medicine, Department of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
Sarah E. Gollust: University of Minnesota School of Public Health, Division of Health Policy and Management, Minneapolis, MN, USA
Rebekah H. Nagler: University of Minnesota Hubbard School of Journalism and Mass Communication, Minneapolis, MN, USA
Mara A. Schonberg: Beth Israel Deaconess Medical Center, Harvard Medical School, Division of General Medicine and Primary Care, Boston, MA, USA
Cynthia M. Boyd: Johns Hopkins University School of Medicine, Department of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
Qian-Li Xue: Johns Hopkins University School of Medicine, Department of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
Yaldah M. Nader: Johns Hopkins University School of Medicine, Department of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
Craig E. Pollack: Johns Hopkins University Bloomberg School of Public Health, Department of Health Policy and Management, Baltimore, MD, USA

Medical Decision Making, 2026, vol. 46, issue 1, 26-34

Abstract: Background Messaging strategies hold promise to reduce breast cancer overscreening. However, it is not known whether they may have differential effects among medical maximizers who prefer to take action about their health versus medical minimizers who prefer to wait and see. Methods In a randomized controlled survey experiment that included 2 sequential surveys with 3,041 women aged 65+ y from a US population-based online panel, we randomized participants to 1) no messages, 2) single exposure to a screening cessation message, or 3) 2 exposures over time to the screening cessation message. We assessed support for stopping screening in a hypothetical patient and intention to stop screening oneself on 7-point scales, where higher values indicated stronger support and intentions to stop screening. We conducted stratified analyses by medical-maximizing preference and moderation analysis. Results Of the women, 40.7% ( n = 1,238) were medical maximizers; they had lower support and intention for screening cessation in all groups compared with the medical minimizers. Two message exposures increased support for screening cessation among medical maximizers, with a mean score of 3.68 (95% confidence interval [CI] 3.51–3.85) compared with no message (mean score 2.20, 95% CI 2.00–2.39, P

Keywords: older adult; breast cancer screening; screening cessation (search for similar items in EconPapers)
Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:46:y:2026:i:1:p:26-34

DOI: 10.1177/0272989X251377458

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