A Thematic Analysis Exploring Bowel Cancer Screening Promotional Visuals in the United Kingdom and India

The purpose of this qualitative study is to explore and identify elements used in bowel cancer screening visuals that promote health literacy and participation in screening tests in the United Kingdom and India.

A total of 17 participants from the United Kingdom and India took part in a thematic analysis study. Individuals were eligible for this study, if they were within the National Health Service bowel cancer screening target between ages 50 and 74 years. A total of 58 bowel cancer screening promotional images were presented to the participants, and they had to indicate whether they believed the image effectively encouraged participation in bowel cancer screening. Then, participants were invited for a remote interview to explore their verbal constructions of the bowel cancer screening images. The interview questions were designed to explore participants' preferences and aversions toward the visual elements used in promoting health literacy around bowel cancer screening.

The findings highlight key visual features that resonate with the target audience and those that may hinder the effectiveness of screening messages. Encouraging elements include images of happy families, the portrayal of screening consequences, clear details about the screening process, and the inclusion of health care professionals. The study also underscores the importance of using both gain-framed and loss-framed messages. In contrast, discouraging elements, such as ambiguous images, such as pictures of toilets, and visuals evoking negative emotions, such as pictures showing internal organs, were identified as barriers to engagement. These visuals may confuse audiences or evoke feelings of disgust, which can deter individuals from participating in screening. The findings suggest that screening promotion materials should incorporate clear, informative visuals that directly relate to the screening process, such as test kits and health care professionals.

The study provides practical recommendations for designing effective, culturally relevant promotional materials that balance informational content with emotional appeal, improving the likelihood of increasing bowel cancer screening uptake.