Worried but Not Intending: When Expressive Suppression Dampens the Motivational Role of Health Worry in Colorectal Cancer Screening Among Older Adults

OBJECTIVES: Health worry may promote engagement in preventive behaviors, but when poorly regulated it can also foster avoidance. This study examined the relationship between health worry and intention to participate in colorectal cancer screening, investigating the moderating role of emotion regulation strategies and age-related differences. METHODS: Within the MIRIADE project, a cross-sectional survey was conducted with 1,451 adults aged 50-74 years, divided into middle-aged (50-60 years) and older adult (61-74 years) groups. Participants completed measures of health worry, cognitive reappraisal, expressive suppression, and screening intention. Moderation analyses were performed separately by age group using PROCESS. RESULTS: Health worry was positively associated with screening intention in both age groups. Cognitive reappraisal predicted higher intention but did not moderate this relationship. Expressive suppression significantly moderated this association only among older adults: health worry predicted higher screening intention at low and moderate levels of suppression, whereas this effect disappeared at high levels of suppression. CONCLUSIONS: Emotion regulation strategies, particularly expressive suppression, influence how health worry translates into screening intentions in later adulthood. CLINICAL IMPLICATIONS: Interventions aimed at increasing cancer screening behaviors in older adults should consider not only health worry, but also the ways individuals regulate emotional experiences associated with health threats.