Eyes on Prevention: An Eye-Tracking Analysis of Visual Attention Patterns in Breast Cancer Screening Ads

Strong communication is central to the translation of breast cancer screening availability into uptake. This experiment tests the role of design features of screening advertisements in directing visual attention in screening-eligible women (≥40 years). To this end, a within-subjects eye-tracking experiment (N = 30) was conducted in which women viewed six static public service advertisements. Predefined Areas of Interest (AOIs), Text, Image/Visual, Symbol, Logo, Website/CTA, and Source/Authority-were annotated, and three standard measures were calculated: Time to First Fixation (TTFF), Fixation Count (FC), and Fixation Duration (FD). Analyses combined descriptive summaries with subgroup analyses using nonparametric methods and generalized linear mixed models (GLMMs) employing participant-level random intercepts. Within each category of stimuli, detected differences were small in magnitude yet trended towards few revisits in each category for the FC mode; TTFF and FD showed no significant differences across categories. Viewing data from the perspective of Areas of Interest (AOIs) highlighted pronounced individual differences. Narratives/efficacy text and dense icon/text callouts prolonged processing times, although institutional logos and abstract/anatomical symbols generally received brief treatment except when coupled with action-oriented communication triggers. TTFF timing also tended toward individual areas of interest aligned with the Scan-Then-Read strategy, in which smaller labels/sources/CTAs are exploited first in comparison with larger headlines/statistical text. Practically, screening messages should co-locate access and credibility information in early-attention areas and employ brief, fluent efficacy text to hold gaze. The study adds PSA-specific eye-tracking evidence for breast cancer screening and provides immediately testable design recommendations for programs in Greece and the EU.