{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T20:39:47Z","timestamp":1792615187328,"version":"4.5.0"},"reference-count":42,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2027,1,1]],"date-time":"2027-01-01T00:00:00Z","timestamp":1798761600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2027,1,1]],"date-time":"2027-01-01T00:00:00Z","timestamp":1798761600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R37CA276317"],"award-info":[{"award-number":["R37CA276317"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Patient Education and Counseling"],"published-print":{"date-parts":[[2027,1]]},"DOI":"10.1016\/j.pec.2026.110338","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:13:32Z","timestamp":1791846812000},"page":"110338","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Effect of gain- and loss-framed messages on women\u2019s responses to negative family cancer history screening results: A randomized online trial"],"prefix":"10.1016","volume":"154","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6377-4626","authenticated-orcid":false,"given":"Yue","family":"Guan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0004-4027","authenticated-orcid":false,"given":"Angelo","family":"Marra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dayanna Ramirez","family":"Leon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1585-8870","authenticated-orcid":false,"given":"Angela","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cam","family":"Escoffery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6723-9540","authenticated-orcid":false,"given":"Lauren E.","family":"McCullough","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen M.","family":"McBride","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"7","key":"10.1016\/j.pec.2026.110338_bib1","doi-asserted-by":"crossref","first-page":"2579","DOI":"10.1002\/cam4.2824","article-title":"A regional population-based hereditary breast cancer screening tool in Italy: first 5-year results","volume":"9","author":"Cortesi","year":"2020","journal-title":"Cancer Med"},{"issue":"1","key":"10.1016\/j.pec.2026.110338_bib2","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1897-4287-8-8","article-title":"Population screening for hereditary and familial cancer syndromes in Valka district of Latvia","volume":"8","author":"Vanags","year":"2010","journal-title":"Hered Cancer Clin Pract"},{"issue":"15","key":"10.1016\/j.pec.2026.110338_bib3","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13154473","article-title":"The use of national cancer registry data for breast cancer family history assessment in premenopausal women","volume":"13","author":"Chodick","year":"2024","journal-title":"J Clin Med"},{"issue":"12","key":"10.1016\/j.pec.2026.110338_bib4","doi-asserted-by":"crossref","first-page":"3014","DOI":"10.1002\/cam4.1210","article-title":"Identification of hereditary cancer in the general population: development and validation of a screening questionnaire for obtaining the family history of cancer","volume":"6","author":"Campacci","year":"2017","journal-title":"Cancer Med"},{"issue":"7","key":"10.1016\/j.pec.2026.110338_bib5","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1001\/jama.2019.10987","article-title":"Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer: US preventive services task force recommendation statement","volume":"322","author":"Preventive Services Task Force","year":"2019","journal-title":"JAMA"},{"issue":"3-4","key":"10.1016\/j.pec.2026.110338_bib6","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1159\/000336419","article-title":"Efficient identification and referral of low-income women at high risk for hereditary breast cancer: a practice-based approach","volume":"15","author":"Joseph","year":"2012","journal-title":"Public Health Genom"},{"issue":"10","key":"10.1016\/j.pec.2026.110338_bib7","doi-asserted-by":"crossref","first-page":"3342","DOI":"10.1245\/s10434-014-3921-1","article-title":"Implementing a screening tool for identifying patients at risk for hereditary breast and ovarian cancer: a statewide initiative","volume":"21","author":"Brannon Traxler","year":"2014","journal-title":"Ann Surg Oncol"},{"issue":"1","key":"10.1016\/j.pec.2026.110338_bib8","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1002\/cncr.33866","article-title":"Increasing referral of at-risk women for genetic counseling and BRCA testing using a screening tool in a community breast imaging center","volume":"128","author":"Arun","year":"2022","journal-title":"Cancer"},{"key":"10.1016\/j.pec.2026.110338_bib9","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.cancergen.2019.04.063","article-title":"Uptake of genetic testing for germline BRCA1\/2 pathogenic variants in a predominantly Hispanic population","volume":"235-236","author":"McGuinness","year":"2019","journal-title":"Cancer Genet"},{"issue":"3-4","key":"10.1016\/j.pec.2026.110338_bib10","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1159\/000503129","article-title":"Do women who receive a negative BRCA1\/2 risk result understand the implications for breast cancer risk?","volume":"22","author":"Guan","year":"2019","journal-title":"Public Health Genom"},{"issue":"5-6","key":"10.1016\/j.pec.2026.110338_bib11","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1159\/000511131","article-title":"Misinterpretation of Hereditary Breast Cancer Risk and Its Association with Information Sharing Motives among Women at Low Likelihood of Carrying a BRCA1\/2 Mutation","volume":"23","author":"Zhao","year":"2020","journal-title":"Public Health Genom"},{"issue":"1","key":"10.1016\/j.pec.2026.110338_bib12","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-055329","article-title":"The effects of health behaviours and beliefs based on message framing among patients with chronic diseases: a systematic review","volume":"12","author":"Gao","year":"2022","journal-title":"BMJ Open"},{"key":"10.1016\/j.pec.2026.110338_bib13","doi-asserted-by":"crossref","DOI":"10.1016\/j.socscimed.2025.117683","article-title":"Sit is not lit: examining the impact of message framing, modality, and peer influence on attitudes and intentions to reduce sedentary behavior","volume":"366","author":"Nirmala","year":"2025","journal-title":"Soc Sci Med"},{"issue":"5","key":"10.1016\/j.pec.2026.110338_bib14","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1093\/geront\/gnaa128","article-title":"Getting to the heart of the matter in later life: the central role of affect in health message framing","volume":"61","author":"Mikels","year":"2021","journal-title":"Gerontologist"},{"issue":"2","key":"10.1016\/j.pec.2026.110338_bib15","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1007\/s12160-015-9757-5","article-title":"When different message frames motivate different routes to the same health outcome","volume":"50","author":"Gerend","year":"2016","journal-title":"Ann Behav Med"},{"issue":"1","key":"10.1016\/j.pec.2026.110338_bib16","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1037\/0033-2909.121.1.3","article-title":"Shaping perceptions to motivate healthy behavior: the role of message framing","volume":"121","author":"Rothman","year":"1997","journal-title":"Psychol Bull"},{"issue":"7","key":"10.1016\/j.pec.2026.110338_bib17","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1080\/10810730701615198","article-title":"The relative persuasiveness of gain-framed and loss-framed messages for encouraging disease prevention behaviors: a meta-analytic review","volume":"12","author":"O'Keefe","year":"2007","journal-title":"J Health Commun"},{"issue":"_1","key":"10.1016\/j.pec.2026.110338_bib18","doi-asserted-by":"crossref","first-page":"S202","DOI":"10.1111\/j.1460-2466.2006.00290.x","article-title":"The strategic use of gain- and loss-framed messages to promote healthy behavior: how theory can inform practice","volume":"56","author":"Rothman","year":"2006","journal-title":"J Commun"},{"key":"10.1016\/j.pec.2026.110338_bib19","article-title":"Effects of gain- and loss-framed messages on preventive nutrition behaviors of osteoporosis in Iranian female students: a text messaging intervention","author":"Shafaeian","year":"2020","journal-title":"Int J Pediatr"},{"key":"10.1016\/j.pec.2026.110338_bib20","article-title":"The influence of gain-framed and loss-framed health messages on nutrition and physical activity knowledge","volume":"6","author":"Fetter","year":"2019","journal-title":"Glob Pediatr Health"},{"issue":"9","key":"10.1016\/j.pec.2026.110338_bib21","doi-asserted-by":"crossref","DOI":"10.2196\/27634","article-title":"Effects of message framing on cancer prevention and detection behaviors, intentions, and attitudes: systematic review and meta-analysis","volume":"23","author":"Ainiwaer","year":"2021","journal-title":"J Med Internet Res"},{"issue":"5","key":"10.1016\/j.pec.2026.110338_bib22","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1007\/s10897-014-9808-2","article-title":"Framing recommendations to promote prevention behaviors among people at high risk: a simulation study of responses to melanoma genetic test reporting","volume":"24","author":"Taber","year":"2015","journal-title":"J Genet Couns"},{"issue":"5","key":"10.1016\/j.pec.2026.110338_bib23","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1037\/hea0001073","article-title":"Effects of culturally targeted message framing on colorectal cancer screening among African Americans","volume":"40","author":"Lucas","year":"2021","journal-title":"Health Psychol"},{"issue":"5","key":"10.1016\/j.pec.2026.110338_bib24","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1007\/s10865-023-00415-9","article-title":"Medical mistrust, culturally targeted message framing, and colorectal cancer screening among African Americans","volume":"46","author":"Aspiras","year":"2023","journal-title":"J Behav Med"},{"issue":"2","key":"10.1016\/j.pec.2026.110338_bib25","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1037\/men0000418","article-title":"Message framing for men? Gender moderated effects of culturally targeted message framing on colorectal cancer screening receptivity among African Americans","volume":"24","author":"Lucas","year":"2023","journal-title":"Psychol Men Masc"},{"issue":"2","key":"10.1016\/j.pec.2026.110338_bib26","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1111\/bjhp.12160","article-title":"Gain versus loss-framed messaging and colorectal cancer screening among African Americans: a preliminary examination of perceived racism and culturally targeted dual messaging","volume":"21","author":"Lucas","year":"2016","journal-title":"Br J Health Psychol"},{"issue":"1","key":"10.1016\/j.pec.2026.110338_bib27","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1186\/s12905-021-01201-y","article-title":"Psychological predictors of intention and avoidance of attending organized mammography screening in Norway: applying the Extended Parallel Process Model","volume":"21","author":"Ivanova","year":"2021","journal-title":"BMC Women\u2019s Health"},{"issue":"22","key":"10.1016\/j.pec.2026.110338_bib28","doi-asserted-by":"crossref","first-page":"1918","DOI":"10.1001\/jama.2024.5534","article-title":"Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement","volume":"331","author":"U. S. Preventive Services Task Force","year":"2024","journal-title":"JAMA"},{"key":"10.1016\/j.pec.2026.110338_bib29","series-title":"Racial and Ethnic Categories and Definitions for NIH Diversity Programs and for Other Reporting Purposes","author":"National Institutes of Health. NOT-OD-15-089","year":"2015"},{"key":"10.1016\/j.pec.2026.110338_bib30","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1080\/10810730.2015.1081997","article-title":"Using the Health Literacy Universal Precautions Toolkit to Improve the Quality of Patient Materials","volume":"20","author":"Brega","year":"2015","journal-title":"J Health Commun"},{"issue":"5","key":"10.1016\/j.pec.2026.110338_bib31","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1177\/1524839914538969","article-title":"The CDC Clear Communication Index is a new evidence-based tool to prepare and review health information","volume":"15","author":"Baur","year":"2014","journal-title":"Health Promot Pract"},{"issue":"2","key":"10.1016\/j.pec.2026.110338_bib32","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/j.1365-2729.2010.00381.x","article-title":"Cognitive load theory vs. constructivist approaches: which best leads to efficient, deep learning?","volume":"27","author":"Vogel-Walcutt","year":"2011","journal-title":"J Comput Assist Learn"},{"issue":"5","key":"10.1016\/j.pec.2026.110338_bib33","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1007\/s11606-008-0520-5","article-title":"Validation of screening questions for limited health literacy in a large VA outpatient population","volume":"23","author":"Chew","year":"2008","journal-title":"J Gen Intern Med"},{"issue":"8","key":"10.1016\/j.pec.2026.110338_bib34","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1111\/j.1525-1497.2006.00532.x","article-title":"Brief report: screening items to identify patients with limited health literacy skills","volume":"21","author":"Wallace","year":"2006","journal-title":"J Gen Intern Med"},{"key":"10.1016\/j.pec.2026.110338_bib35","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1186\/1472-6963-5-64","article-title":"Development of abbreviated measures to assess patient trust in a physician, a health insurer, and the medical profession","volume":"5","author":"Dugan","year":"2005","journal-title":"BMC Health Serv Res"},{"issue":"6","key":"10.1016\/j.pec.2026.110338_bib36","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1007\/s11606-008-0575-3","article-title":"Development of a revised Health Care System Distrust scale","volume":"23","author":"Shea","year":"2008","journal-title":"J Gen Intern Med"},{"key":"10.1016\/j.pec.2026.110338_bib37","doi-asserted-by":"crossref","DOI":"10.1016\/j.clinimag.2023.110066","article-title":"Disparities in genetic testing for breast cancer among black and Hispanic women in the United States","volume":"107","author":"Olufosoye","year":"2024","journal-title":"Clin Imaging"},{"issue":"5","key":"10.1016\/j.pec.2026.110338_bib38","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1007\/s10865-012-9443-z","article-title":"Perceived risk for breast cancer and its relationship to mammography in Blacks, Hispanics, and Whites","volume":"36","author":"Orom","year":"2013","journal-title":"J Behav Med"},{"issue":"1","key":"10.1016\/j.pec.2026.110338_bib39","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1007\/s12160-011-9308-7","article-title":"Health message framing effects on attitudes, intentions, and behavior: a meta-analytic review","volume":"43","author":"Gallagher","year":"2012","journal-title":"Ann Behav Med"},{"issue":"2","key":"10.1016\/j.pec.2026.110338_bib40","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1111\/j.1460-2466.2009.01417.x","article-title":"The relative persuasiveness of gain-framed and loss-framed messages for encouraging disease detection behaviors: a meta-analytic review","volume":"59","author":"O'Keefe","year":"2009","journal-title":"J Commun"},{"key":"10.1016\/j.pec.2026.110338_bib41","first-page":"123","article-title":"The Elaboration Likelihood Model of Persuasion","volume":"19","author":"Petty","year":"1986"},{"issue":"9","key":"10.1016\/j.pec.2026.110338_bib42","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1080\/10410236.2017.1331305","article-title":"Starting off on the best foot: a review of message framing and message tailoring, and recommendations for the comprehensive messaging strategy for sustained behavior change","volume":"33","author":"Pope","year":"2018","journal-title":"Health Commun"}],"container-title":["Patient Education and Counseling"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0738399126008712?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0738399126008712?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:47:38Z","timestamp":1792612058000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0738399126008712"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2027,1]]},"references-count":42,"alternative-id":["S0738399126008712"],"URL":"https:\/\/doi.org\/10.1016\/j.pec.2026.110338","relation":{},"ISSN":["0738-3991"],"issn-type":[{"value":"0738-3991","type":"print"}],"subject":[],"published":{"date-parts":[[2027,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Effect of gain- and loss-framed messages on women\u2019s responses to negative family cancer history screening results: A randomized online trial","name":"articletitle","label":"Article Title"},{"value":"Patient Education and Counseling","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.pec.2026.110338","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier B.V.","name":"copyright","label":"Copyright"}],"article-number":"110338"}}