{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:43:59Z","timestamp":1792053839006,"version":"4.4.0"},"reference-count":32,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Promotion Practice"],"abstract":"<jats:p>\n                    Health communication campaigns increase awareness but do not consistently produce behavior change, in part because theory is not systematically integrated across communication development. This article introduces the\n                    <jats:italic toggle=\"yes\">DRIVE<\/jats:italic>\n                    Framework (\n                    <jats:italic toggle=\"yes\">Discover<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Refine<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Investigate<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Validate<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Execute<\/jats:italic>\n                    ), a staged approach designed to intentionally link formative research, message development, testing, and real-world implementation through structured theory integration. Colorectal cancer screening (CRCS) messaging for newly eligible rural adults aged 45 to 49 in West Virginia served as an application example using data collected from 2024 to 2026. During\n                    <jats:italic toggle=\"yes\">Discover<\/jats:italic>\n                    (\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    = 345), a cross-sectional survey guided by the Health Belief Model identified low perceived threat, lower self-efficacy, and elevated barriers. These findings informed theory-aligned message development in\n                    <jats:italic toggle=\"yes\">Refine<\/jats:italic>\n                    using the Extended Parallel Process Model to increase urgency while reinforcing efficacy. In\n                    <jats:italic toggle=\"yes\">Investigate<\/jats:italic>\n                    (\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    = 104), theory-informed messages significantly increased CRCS intention and motivation (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; .001) compared with predominant messaging in an experimental survey. In\n                    <jats:italic toggle=\"yes\">Validate<\/jats:italic>\n                    (\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    = 600), patients from a partner health system were randomized to receive either a theory-informed postcard or a postcard reflecting the predominant communication approach. Theory-informed postcards significantly increased CRCS referral rates (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; .001). Completion rates were also higher (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = .050). Finally,\n                    <jats:italic toggle=\"yes\">Execute<\/jats:italic>\n                    integrated validated strategies into an existing statewide initiative. Across stages, the theory functioned diagnostically, generatively, evaluatively, and operationally, demonstrating how staged integration can enhance transparency, strengthen message effectiveness, and support real-world implementation. For practice and policy,\n                    <jats:italic toggle=\"yes\">DRIVE<\/jats:italic>\n                    offers a structured pathway to strengthen communication effectiveness and improve return on investment across population-based health promotion programs.\n                  <\/jats:p>","DOI":"10.1177\/15248399261489195","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T09:32:13Z","timestamp":1791797533000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The DRIVE Framework for Theory-Integrated Health Communication Development: An Application to Rural Colorectal Cancer Screening"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0219-0322","authenticated-orcid":false,"given":"Dannell","family":"Boatman","sequence":"first","affiliation":[{"name":"West Virginia University Cancer Institute, Morgantown, USA"},{"name":"West Virginia University School of Medicine, Morgantown, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abby","family":"Starkey","sequence":"additional","affiliation":[{"name":"West Virginia University Cancer Institute, Morgantown, USA"},{"name":"West Virginia University School of Medicine, Morgantown, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Eason","sequence":"additional","affiliation":[{"name":"West Virginia University Cancer Institute, Morgantown, USA"},{"name":"West Virginia University School of Medicine, Morgantown, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa","family":"Watson","sequence":"additional","affiliation":[{"name":"West Virginia University Cancer Institute, Morgantown, USA"},{"name":"West Virginia University School of Medicine, Morgantown, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raimah","family":"Hossain","sequence":"additional","affiliation":[{"name":"West Virginia University Cancer Institute, Morgantown, USA"},{"name":"West Virginia University School of Medicine, Morgantown, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Jarrett","sequence":"additional","affiliation":[{"name":"West Virginia University Cancer Institute, Morgantown, USA"},{"name":"West Virginia University School of Medicine, Morgantown, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eden","family":"Williams","sequence":"additional","affiliation":[{"name":"West Virginia University Cancer Institute, Morgantown, USA"},{"name":"West Virginia University School of Medicine, Morgantown, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5427-5865","authenticated-orcid":false,"given":"Amy R.","family":"Allen","sequence":"additional","affiliation":[{"name":"West Virginia University Cancer Institute, Morgantown, USA"},{"name":"West Virginia University School of Medicine, Morgantown, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7230-1484","authenticated-orcid":false,"given":"Stephenie","family":"Kennedy-Rea","sequence":"additional","affiliation":[{"name":"West Virginia University Cancer Institute, Morgantown, USA"},{"name":"West Virginia University School of Medicine, Morgantown, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"crossref","unstructured":"Boatman D. 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