Preferences for cervical cancer screening: The role of implicit associations

Objectives

Implicit associations influence behaviour, but their impact on cancer screening intentions is unknown.

Methods

We assessed implicit associations with cervical cancer screening using an evaluative priming task. Participants were shown primes (‘Pap test’, neutral or non-word) followed by positive or negative target words. The test is based on the assumption that response times are shorter if primes and targets are strongly associated in the participant's mind. The Dutch screening program targets women aged 30–60, 226 of them completed online assessments twice. Prior to the second assessment participants were randomized to reading versus not reading the leaflet about the cervical screening program.

Results

After controlling for knowledge and screen history, response times for ‘Pap test’ no longer differed between positive and negative targets. Implicit associations were not correlated with explicit attitudes or screening intentions. Reading the screening leaflet resulted in improved knowledge levels (p < 0.001), but implicit associations, explicit attitudes, and screening intentions remained similar.

Conclusion

Cervical cancer screening intentions were related to explicit attitudes, but not to implicit associations. The screening leaflet did not affect screening intentions.

Practice implications

We recommend achieving a deepened interest in the screening program among risk groups, e.g. by adapting the information leaflet.