Advancing cancer prevention: Optimizing messages

This is a multi-site study funded by Cancer Research UK through a Cancer Research UK/National Cancer Institute Knowledge Integration Sandpit. Half of the qualitative interviews will be conducted by ECU. The main quantitative survey will be conducted by ECU. Qualitative analysis will be conducted by University of Glasgow. The qualitative study will inform the design of the quantitative study. Quantitative analysis will be conducted by Florida International University. University College London will conduct a small pilot experiment also using Qualtrics Panels. BACKGROUND Tobacco, alcohol, and sugar consumption contribute to cancer burden. An evidence-based population-level intervention to reduce intake of tobacco, alcohol, and sugar-added products is the implementation of policies that increase their price. This can be done through excise taxes, mitigation fees, bans on discounts, and minimum prices. Yet, the adoption of these evidence-based policies has received only limited traction, and public support is undermined by industry-led efforts to oppose policy interventions. This proposal is guided by a working hypothesis that public acceptance of different tax and non-tax pricing interventions for cancer risk behaviors varies by: (a) policy type, (b) the way the message is framed, and (c) the cancer-causing product it addresses. AIMS We examine this working hypothesis through specific aims to: (1) identify and optimize ways to communicate price policy options for cancer-causing products to the public and (2) explore the effects of policy type, frames, and behavioural domain on public policy support. PARTICIPANTS Participants in the interview stage (qualitative) will be: 6 members of the public, 6 cancer survivors, and 6 cancer policy advocates – half of each stakeholder group will be in each country. Participants in the quantitative study will be solicited by Qualtrics's Survey Panels service (n=1800). METHODS This project will use a mixed-methods approach to understand the framing of tax and non- tax pricing policy interventions to reduce consumption of cancer-causing products. We will conduct formative qualitative research with stakeholders, identify frames to test, and pilot the frames in a quantitative study. We will then implement a 3x3x4 factorial experiment to assess the impact of the frames, cancer-causing products discussed, and pricing policy options on support for policies among UK and US adults.

本研究为一项多中心研究，由英国癌症研究中心（Cancer Research UK）通过英国癌症研究中心/美国国家癌症研究所（National Cancer Institute）知识整合沙箱项目资助。半数质性访谈与核心量化调查将由ECU牵头开展。质性分析工作由格拉斯哥大学（University of Glasgow）负责完成，本质性研究将为量化研究的设计提供参考依据。量化分析工作由佛罗里达国际大学（Florida International University）承担。伦敦大学学院（University College London）将依托Qualtrics面板（Qualtrics Panels）开展一项小型预实验。

一、研究背景
烟草、酒精及添加糖食品的消费是全球癌症负担的重要致病诱因。针对降低烟草、酒精及添加糖食品摄入的循证人群级干预措施，可通过出台抬升此类产品价格的政策实现，具体手段包括征收消费税、设置调节费、禁止折扣优惠及设定最低定价。然而，此类循证政策的推行仅获得了有限的进展，公众支持度因行业主导的反对政策干预的宣传活动而受到削弱。本研究基于以下工作假设：公众对针对癌症风险行为的各类税费及非税费定价干预措施的接受度，会因（a）政策类型、（b）信息框架，以及（c）所针对的致癌产品而异。

二、研究目标
本研究通过以下两项具体目标验证上述工作假设：（1）识别并优化面向公众传递致癌产品价格政策选项的沟通策略；（2）探究政策类型、信息框架及行为领域对公众政策支持度的影响。

三、研究对象
质性访谈阶段的研究对象包括：6名普通公众、6名癌症幸存者及6名癌症政策倡导者，每个利益相关者群体中的半数参与者将分别来自英国与美国。量化研究的研究对象将通过Qualtrics调研面板（Qualtrics's Survey Panels）招募，总样本量为1800例。

四、研究方法
本项目将采用混合研究方法，解析针对降低致癌产品消费的税费及非税费定价政策干预的信息框架。研究团队将首先与利益相关者开展形成性质性研究，确定待测试的信息框架，并在量化研究中对框架进行预测试。随后将实施一项3×3×4析因实验（factorial experiment），以评估信息框架、所讨论的致癌产品类型及定价政策选项对英国与美国成年人政策支持度的影响。