Mapping the Gaze: Comparing the Effectiveness of Bowel-Cancer Screening Advertisements

Public-health campaigns have to capture and hold visual attention, but little is known about the influence of message framing and visual appeal on attention to bowel-cancer screening ad campaigns. In a within-subjects test, 42 UK adults aged 40 to 65 viewed 54 static adverts that varied by (i) slogan frame—anticipated regret (AR) vs. positive (P); (ii) image type—hand-drawn, older stock, AI-generated; and (iii) identity congruence—viewer ethnicity matched vs. unmatched to the depicted models. Remote eye-tracking measured time to first fixation (TTFF), dwell, fixations, and revisits on a priori pre-defined regions of interest (ROIs); analyses employed linear mixed-effects models (LMMs), generalized estimating equations (GEEs), and median quantile regressions with cluster at the participant level. Across models, the AR slogans produced faster orienting (smaller TTFF) and more intense maintained attention (longer dwell, more fixations and revisits) than the P slogans. Image type set baseline attention (hand-drawn > old stock > AI) but did not significantly decrease the AR benefit, which was equivalent for all visual styles. Identity congruence enhanced early capture (lower TTFF), with small effects for dwell-based measures, suggesting that tailoring benefits only the “first glance.” Anticipated-regret framing is a reliable, design-level alternative to improving both initial capture and sustained processing of screening messages. In practice, the results indicate that advertisers should pair regret-based slogans with warm, human-centred imagery; place slogans in high-salience, low-competition spaces, and, when incorporating AI-generated imagery, reduce composition complexity and exclude uncanny details. These findings ground regret framing as a visual-attention mechanism for public-health campaigns in empirical fact and provide practical recommendations for testing and production.