Testing whether barriers to a hypothetical screening test affect unrelated perceived benefits and vice versa: A randomised, experimental study

OBJECTIVE Determine whether (fictitious) health screening test benefits affect perceptions of (unrelated) barriers, and barriers affect perceptions of benefits. METHODS UK adults were recruited via an online survey panel and randomised to receive a vignette describing a hypothetical screening test with either high or low benefits (higher vs. lower mortality reduction) and high or low barriers (severe vs. mild side-effects; a 2×2 factorial design). ANOVAs compared mean perceived benefits and barriers scores. Screening 'intentions' were compared using Pearson's χ2 test. RESULTS Benefits were rated less favourably when barriers were high (mean: 27.4, standard deviation: 5.3) than when they were low (M: 28.5, SD: 4.8; p=0.010, partial η2=0.031). Barriers were rated more negatively when benefits were low (M: 17.1, SD: 7.6) than when they were high (M: 15.7, SD: 7.3; p=0.023, partial η2=0.024). Most intended to have the test in all conditions (73-81%); except for the low benefit-high barrier condition (37%; p<0.0005; N=218). CONCLUSIONS Perceptions of test attributes may be influenced by unrelated characteristics. PRACTICE IMPLICATIONS Reducing screening test barriers alone may have suboptimal effects on perceptions of barriers if benefits remain low; increasing screening benefits may not improve perceptions of benefits if barriers remain high.