A qualitative study exploring Malaysian women’s preferences for authority or emotional appeals in public health messages promoting breast cancer screening

Persuasive health communication is key to promoting breast cancer screening. Due to existing gaps over how public health messages should be framed, a study was conducted to explore the preferences and perceptions of Malaysian women towards messages that incorporate different types of appeals to promote breast cancer screening. In-depth qualitative interviews were conducted among Malaysian women aged 40 and above with no previous history of breast cancer or other cancers. They were exposed to messages that promoted breast cancer screening using seven different appeals; authority, hope, social, humour, fear, sadness, and shame-guilt. Qualitative expressions for preferences and perceptions were analysed using interpretive thematic analysis. 41 Malaysian women were interviewed. The majority preferred messages that incorporated hope, authority, or fear appeals. Messages with an authority appeal were favoured for their personalised and authoritative effect. Messages using hope and fear appeals elicited emotional reactions and cognitive appraisals that contributed to their favourability. In contrast, humour, sadness, and shame-guilt were the most disliked appeals. The humour appeal was generally disliked because it caused interpretations that weakened the persuasive impact of the advocated behaviour in the message. Messages incorporating sadness and shame-guilt appeals were disliked primarily due to their negative framing. In conclusion, public health messages incorporating hope, authority, or fear appeals show promising potential to motivate breast cancer screening among Malaysian women, and their effectiveness in influencing actual behaviour change should be further explored.