Use of the Persuasive Health Message Framework in a Mammography Promotion Campaign

African American women who get breast cancer are more likely to die from the disease than white women, and are less likely to survive for 5 years after diagnosis. Studies suggest that this disparity is due, in part, to African American women being diagnosed with breast cancer at a later stage, and receiving treatment later after diagnosis.

The Persuasive Health Message (PHM) framework was used to guide the development of messages and materials used in the African American Women and Mass Media (AAMM) pilot campaign, which was intended to encourage low-income African American women to get free or low-cost mammograms through CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP). The PHM framework outlines how to develop effective and persuasive campaigns by combining parts of successful theories about human behavior.

In Savannah and Macon, Georgia, in 2004, the study recruited 78 African American women between 40 and 64 years old who were eligible for a mammogram through the NBCCEDP. Women are eligible to receive services through the NBCCEDP if they don’t have health insurance or if their insurance doesn’t cover breast and cervical cancer screenings, and their family income is below 250% of the federal poverty level. Women with a personal history of any cancer were excluded, as were women who had a relative participating in the study. Participant responses were used to develop messages for the AAMM.

Key Findings

The PHM framework specifies the following steps—

  1. Determine information about threat and efficacy (determine audience beliefs, specify the desired response, and determine barriers to taking the desired action).
  2. Develop a profile of the target audience (assess the audience’s cultural and environmental information and identify audience preferences for channel, message, and source).
  3. Construct persuasive messages using the information gathered (create messages that fit with audience beliefs, reinforce existing beliefs, or introduce new beliefs), test the messages, and change them as needed.


Hall IJ, Johnson-Turbes A. Use of the Persuasive Health Message framework in the development of a community-based mammography promotion campaign.external icon Cancer Causes and Control 2015;26(5):775–784.