Humor-Based Interventions for Colorectal Cancer Screening: Reappraisal Pathways and the Moderating Roles of Health Anxiety and Cancer Information Overload

Colorectal cancer (CRC) screening remains underused, in part because screening-related stressors can elicit fear, embarrassment, and other emotional barriers. Guided by the process model of emotion regulation, this study examined whether humor-based interventions engage cognitive reappraisal of CRC screening stressors and whether these reappraisal processes support screening intention. In a randomized experiment with 180 U.S. adults aged 45-75, participants received pre-crafted humor messages (PHM), completed self-generated humor tasks (SHT), or viewed an emotionally neutral control. Humorous and serious reappraisal were tested as parallel mediators, with health anxiety (HA) and cancer information overload (CIO) examined as moderators. Both PHM and SHT increased humorous reappraisal relative to control, and humorous reappraisal linked each intervention to stronger screening intention. Serious reappraisal did not mediate either intervention overall. Moderated mediation analyses showed that HA strengthened SHT's indirect effect through humorous reappraisal, whereas CIO strengthened SHT's indirect effect through serious reappraisal. The corresponding moderated pathways were not significant for PHM. These findings identify reappraisal as a pathway linking humor interventions with screening intention and suggest that self-generated humor may engage different reappraisal processes under heightened health-focused attention and information overload.