Graduation Year

2026

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Psychology

Major Professor

Diana Rancourt, Ph.D.

Co-Major Professor

Vani Simmons, Ph.D.

Committee Member

Jennifer Vidrine, Ph.D.

Committee Member

Damon Vidrine, Ph.D.

Committee Member

Robert Schlauch, Ph.D.

Committee Member

Kristen Salomon, Ph.D.

Keywords

Health Communication, Cancer Prevention, Smoking, Stigma

Abstract

Lung cancer is the number one cause of cancer-related death in the United States and worldwide. Lung cancer screening with low-dose computed tomography (LDCT) has been associated with a 20% reduction in lung cancer-related mortality. Despite the obvious benefits of lung cancer screening with LDCT, screening is heavily underutilized compared to other cancer screening tests. Thus, it is critically important to develop strategies that help motivate screening uptake among eligible individuals. This study explored the effectiveness of narrative messages for motivating lung cancer screening uptake among individuals eligible for lung cancer screening who currently smoke or formerly smoked. Drawing from seminal theories of health behavior change, including the Extended Parallel Process Model and the Health Belief Model, and a theory of narrative persuasion, Deictic Shift Theory, a series of narrative messages, delivered in brief video format, were created. 333 participants were recruited for this study and randomized to one of three message conditions (narrative, didactic, or control), where they watched three assigned videos. Before and after message exposure, participants answered questionnaires related to knowledge of lung cancer screening, health beliefs about lung cancer and lung cancer screening, and intention to receive lung cancer screening. A series of multiple regression analyses were conducted examining message type (narrative vs. didactic) as a predictor of outcomes related to lung cancer screening. Analyses revealed no significant differences between narrative and didactic messages on any of our hypothesized outcome measures. However, post-hoc stratified regression analyses by smoking status (current vs. former) revealed significant differences between narrative and didactic messages for individuals who currently smoke, such that narrative messages led to significantly greater increases in self-reported intention to receive lung cancer screening and response-efficacy for lung cancer screening, compared to didactic messages. Narrative transportation, a mechanism of narrative persuasion, was a significant predictor of outcome variables related to lung cancer screening for all participants in the narrative condition, regardless of smoking status. These results add to the literature on lung cancer screening interventions and underscore the potential utility of narrative communication for individuals who currently smoke.

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