The Role of Thinking Styles in Cancer Prevention Behaviour: A Systematic Review Protocol

Uyen Ngo; Rana Ahmed; Amy McQueen; Pamela Gallagher; Alice Le Bonniec; Linda Sharp; Christian Von Wagner; Caitriona Cahir; Kathleen Bennett; Nicholas Clarke

doi:10.12688/hrbopenres.14410.1

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Study Protocol

The Role of Thinking Styles in Cancer Prevention Behaviour: A Systematic Review Protocol

[version 1; peer review: awaiting peer review]

Uyen Ngo ¹, Rana Ahmed¹, Amy McQueen², [...] Pamela Gallagher³, Alice Le Bonniec⁴, Linda Sharp⁵, Christian Von Wagner⁶, Caitriona Cahir⁷, Kathleen Bennett⁷, Nicholas Clarke¹

Uyen Ngo ¹, Rana Ahmed¹, [...] Amy McQueen², Pamela Gallagher³, Alice Le Bonniec⁴, Linda Sharp⁵, Christian Von Wagner⁶, Caitriona Cahir⁷, Kathleen Bennett⁷, Nicholas Clarke¹

PUBLISHED 21 Apr 2026

Author details Author details

¹ Converge: Centre for Chronic Disease and Population Health, School of Population Health, Royal College of Surgeons in Ireland, Dublin, Leinster, Ireland
² School of Public Health, Washington University in St Louis, St. Louis, Missouri, USA
³ School of Psychology, Dublin City University, Dublin, Leinster, Ireland
⁴ National Screening Service Ireland, National Screening Service Ireland, Dublin, Ireland
⁵ Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England, UK
⁶ Department of Epidemiology and Public Health, University College London, London, UK
⁷ Data Science Centre, School of Population Health, Royal College of Surgeons in Ireland, Dublin, Leinster, Ireland

Uyen Ngo
Roles: Conceptualization, Investigation, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing

Rana Ahmed
Roles: Conceptualization, Methodology, Writing – Review & Editing

Amy McQueen
Roles: Conceptualization, Writing – Review & Editing

Pamela Gallagher
Roles: Conceptualization, Writing – Review & Editing

Alice Le Bonniec
Roles: Resources, Writing – Review & Editing

Linda Sharp
Roles: Conceptualization, Writing – Review & Editing

Christian Von Wagner
Roles: Conceptualization, Writing – Review & Editing

Caitriona Cahir
Roles: Conceptualization, Supervision, Writing – Review & Editing

Kathleen Bennett
Roles: Conceptualization, Supervision, Writing – Review & Editing

Nicholas Clarke
Roles: Conceptualization, Funding Acquisition, Investigation, Methodology, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing

OPEN PEER REVIEW

REVIEWER STATUS AWAITING PEER REVIEW

Abstract

Background

Prevention plays a crucial role in reducing the burden of cancer. The European Code Against Cancer (ECAC) is a key component of cancer prevention initiatives, providing 14 recommendations across primary and secondary prevention. Building on the core of secondary prevention, organised cancer screening is effective in reducing cancer-related mortality and in some cases cancer incidence. However, suboptimal screening uptake limits the success of these programmes. Evidence suggests that cognitive factors, such as thinking style, may be useful targets for cancer prevention interventions. The Rational-Experiential Inventory (REI) measures two independent thinking style modes: rational thinking (measured by Need For Cognition - NFC) and experiential thinking (measured by Faith in Intuition - FI).

Objective

This review aims to synthesise evidence on the influence of thinking styles (measured by REI, NFC, or FI) on cancer prevention behaviour (guided by ECAC) and investigate whether thinking styles differ across sociodemographic factors.

Methods and analysis

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search will be conducted across electronic databases (Scopus, Web of Science, EMBASE, MEDLINE, CINAHL, PsycINFO, and CENTRAL). Eligibility criteria are defined using the Population, Exposure, Comparison, and Outcome (PECO) framework and include quantitative, peer-reviewed studies, examining associations between thinking styles and cancer prevention behaviours. Title and abstract screening, data extraction and risk of bias assessment will be performed by two independent reviewers. Extracted data (study and population characteristics, cancer prevention behaviours, thinking styles profiles, conceptual and theoretical frameworks and outcomes) will be reported using narrative synthesis and meta-analysis if appropriate.

Conclusion

This review aims to inform the evidence base on the role of thinking style in cancer prevention research. The evidence generated from this systematic review will inform the future development of cancer prevention interventions, with the ultimately aim of reducing cancer mortality and incidence.

Keywords

thinking styles, cancer prevention, health messages, behaviour changes

Corresponding author: Uyen Ngo

Competing interests: No competing interests were disclosed.

Grant information: This review is funded by a Health Research Board (HRB) Emerging Investigator Award [EIA-12-022]. Uyen Ngo is a SPHeRE PhD scholar funded by the HRB (EIA-12-022). Nicholas Clarke is supported by Grants from the HRB[EIA-12-022] and Research Ireland [22/RP/10091]. Linda Sharp is supported by the National Institute for Health and Care Research (NIHR) Newcastle Patient Safety Research Collaboration (PSRC). The views expressed are those of the authors and not necessarily those of the NIHR or Department of Health and Social Care.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Copyright: © 2026 Ngo U et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Ngo U, Ahmed R, McQueen A et al. The Role of Thinking Styles in Cancer Prevention Behaviour: A Systematic Review Protocol [version 1; peer review: awaiting peer review]. HRB Open Res 2026, 9:40 (https://doi.org/10.12688/hrbopenres.14410.1) First published: 21 Apr 2026, 9:40 (https://doi.org/10.12688/hrbopenres.14410.1) Latest published: 21 Apr 2026, 9:40 (https://doi.org/10.12688/hrbopenres.14410.1)

1. Background

The burden of cancer continues to grow, driven by population growth and ageing. By 2045, the global incidence of cancer at all ages is projected to increase to 32.6 million cases, with mortality reaching 16.9 million deaths annually.¹ Cancer prevention and screening play crucial roles in reducing the burden of cancer, and it is estimated that these approaches have saved approximately 4.75 million lives of the six million cancer deaths prevented between 1975 and 2020.² Although Europeans make up less than 10% of the global population, they account for nearly one-fifth of global cancer cases and cancer-related deaths worldwide,¹ with cancer being the second leading cause of death in Europe.³

The European Code Against Cancer (ECAC) is a key component of cancer prevention initiatives in Europe, and provides 14 recommendations targeting both primary and secondary prevention.⁴ These primary prevention actions involve reducing exposure to risk factors such as tobacco smoke (active or passive smoking), alcohol consumption, air pollution, hormone replacement therapy, sun exposure, workplace-related carcinogens and indoor radon. The recommended primary prevention actions also include increasing protective factors such as maintaining a healthy weight, increasing physical activity, adhering to a healthy diet, breastfeeding and getting vaccinated.

Secondary prevention actions include testing for cancer-causing infections (e.g. HPV, and Helicobacter pylori) and, importantly, organised cancer screening programmes (OCSPs) targeting colorectal, breast, cervical and lung cancers. OCSPs aim to identify cancer at the earliest possible stage or, where possible, pre-cancerous lesions.⁴ However, persistent and suboptimal uptake and sociodemographic disparities limit the effectiveness of these programmes.^5–8 Participation rate tends to be less favorable to males, younger and more socioeconomically disadvantaged groups, such as those with lower education, living in deprived or rural areas, or not in a co-habiting relationship in many cancer screening programmes.^6,9–12 A similar pattern of inequities is found in primary cancer prevention, such as smoking cessation and cancer-related vaccine uptake.^13–15 For example, evidence suggests that females^13,14 and individuals with lower socioeconomic status (SES)^14,15 are more likely to have a quit attempt, but that these attempts are not likely to be successful.¹⁵ SES-related differences, including educational level, are also associated with cancer-related vaccine uptake, such as Human Papillomavirus (HPV) and Hepatitis B virus (HBV).¹⁶

The effectiveness of interventions to improve uptake in cancer screening (e.g. patient education, patient invitations and reminders, provider interventions, reducing out-of-pocket client costs, reducing structural barriers)¹⁷ and cancer prevention behaviours (e.g. physician advice, individual counselling, work-based or school-based activities)^18,19 varies.^17,19 The limited effectiveness is due, in part, to a lack of underlying theoretical grounding or understanding about determinants of behaviours.²⁰

Emerging evidence suggests that psychological factors can play a central role in cancer screening uptake barriers,^21,22 such as fear,^23–25 fatalism,²⁶ anxiety, and feelings of disgust (specifically in CRC screening).^26,27 While psychological factors are often seen as emotion-driven, they reflect an underlying pattern of information processing (e.g. how individuals interpret and give personal meaning to cancer-related information) in which cognitive-coping appraisals of the person-environment relationship generate corresponding emotions and subsequent adaptational decisions.²² In this regard, information processing is a crucial part of how people think about and understand cancer-related information.^22,28

The Rational-Experiential Inventory (REI) was developed within Cognitive-Experiential Self-theory (CEST) and measures the extent of individuals’ engagement and ability in interpreting and responding to events using experiential and rational thinking styles.^29,30 The rational thinking style often refers to a slow, conscious, analytical, primarily verbal reasoning, and relies on learning that follows explicit rules and logic with minimal influence from emotions or feelings,³¹ and is measured by the Need For Cognition (NFC) scale.³² Alternatively, the experiential thinking style is a cognitive processing system that is preconscious, rapid, primarily nonverbal reasoning, and intimately associated with experiences of emotions and feelings,³¹ and is measured by the Faith in Intuition (FI) scale.³⁰ These two systems function independently and interactively in parallel, contributing to behaviour.^29,33,34 Individuals can exhibit a preference for engaging in either high or low levels of both thinking styles across various situations.^29,30 Some evidence indicates that matching the message to recipients’ thinking style preferences may increase cancer screening intention and uptake,³⁵ while a preference for rational thinking has been associated with positive perceptions of cancer screening invitation letters in the UK, as well as higher self-reported participation in digital rectal examinations among males in Australia.³⁶ In the context of vaccination, studies generally suggest a positive, direct association between experiential thinking and the likelihood of being vaccine-hesitant.^28,37

To the best of our knowledge, this review is the first evidence synthesis on the role of thinking style in cancer prevention. Given the suboptimal uptake rates among OCSPs and the substantial inequity that exists in primary and secondary cancer prevention, a comprehensive understanding of this relationship is needed. Such insight will provide an evidence base on the role of thinking style in cancer prevention research.

2. Aim and objectives

This review aims to systematically identify, synthesise and summarise published findings on the role of thinking style in cancer prevention studies that have utilised the REI, NFC, or FI measures. The specific objectives are:

(1) To synthesise evidence on thinking styles (REI, NFC, FI) and differences in these styles across sociodemographic groups (e.g., age, sex, SES).
(2) To synthesise evidence on the association between thinking styles (REI, NFC, FI) and cancer prevention behaviours/outcomes, and examine how this association varies across sociodemographic groups.

3. Methods

This systematic review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.³⁸ The review has been registered on PROSPERO (No: CRD420251246809).

3.1. Eligibility criteria

This review will investigate the role of thinking style in cancer prevention research, focusing on thinking styles measured by the REI, NFC, or FI. The eligibility criteria for inclusion are defined using the Population, Exposure, Comparison, and Outcome (PECO) framework ( Table 1). The population (P) of interest includes cancer-asymptomatic adults aged 18 years or older. The exposure (E) is the thinking style as measured by the REI, NFC or FI. Comparisons (C) include differences in REI, NFC and FI scores across study populations. Outcomes (O) focus on main outcomes (e.g. uptake, adherence) and additional outcomes (e.g. intentions) of cancer prevention behaviours (as guided by the 14 recommendations of the European Code Against Cancer) ( Table 1).⁴

Table 1. Search strategy using the population, exposure, comparison and outcome framework.

Element	Inclusion criteria	Exclusion criteria
Population	Studies with cancer-asymptomatic adults aged 18 years and older with cancer before	• Studies with any participants under 18 years of age • Studies with cancer patients, cancer survivors, or individuals with a personal history of cancer
Exposure	Studies that measure thinking style using the Rational-Experiential Inventory (REI, any version), Need for Cognition (NFC, any version), or Faith in Intuition (FI, any version) as the primary or key measure	Studies focusing on thinking styles, rationality, intuition, or related constructs but do not use (entire questionnaire or any items) REI, NFC, FI, or any of their validated short forms as measurement tools
Comparison	Studies comparing REI, NFC or FI scores across study populations and subgroups.
Outcome	Studies that examine associations (including uptake, adherence, and/or behavioural intention outcomes) with cancer prevention behaviours guided by the 14 recommendations of the European Code Against Cancer (ECAC, 5th edition). Included topics: - Participation in cancer screening - Smoking/tobacco/vaping - Second-hand smoke - Weight management - Physical activity & sedentary behaviour reduction - Dietary patterns - Alcohol avoidance - Breastfeeding - Sun protection - Occupational carcinogen exposure - Radon mitigation - Air pollution reduction (active travel, etc.) - Infection-related prevention - Appropriate/limited hormone replacement therapy	• Studies whose primary outcomes are only attitudes, beliefs, risk/benefit perceptions, or knowledge • Studies on behaviours clearly outside the preventive scope of the ECAC (e.g. COVID-19 vaccination, well-being in general, metal health, media makerting)
Study design	Quantitative studies (cross-sectional, cohort, case-control, experimental, or mixed-methods with a clear quantitative component) that report statistical associations between thinking-style scores and the outcome(s) of interest.	Qualitative-only studies, reviews, editorials, commentaries, conference abstracts without full data, study protocols without results, or case reports/series.
Other	• Peer-reviewed journal articles • Published in English Any publication year (or add a date limit if desired)	Grey literature, dissertations, book chapters, or non-peer-reviewed sources (theses, dissertations)

Articles in this review will be eligible if they report on thinking style profiles (using REI, NFC or FI) within the domains of the 14 cancer prevention recommendations of the European Code Against Cancer⁴ ( Table 1). English-language, full-text, peer-reviewed studies will be eligible for inclusion. Eligible study designs will include, but are not limited to, randomised controlled trials, non-randomised controlled trials, quasi-experimental studies, natural experiments of interventions, and observational studies (cohort, case-control, and cross-sectional), as well as mixed methods studies where the quantitative component includes an REI measure. Qualitative research will be excluded, as the focus is on synthesising quantitative data. Articles will be excluded if they are grey literature, are conducted in a context other than cancer prevention, use other thinking style measures (other than the REI, FI, or NFC), or are reviews, opinion pieces, commentaries or conference abstracts. Articles published in languages other than English will be excluded, although the number of such studies (LOE) will be reported.

3.2. Search

The search strategy will be developed in collaboration with an information specialist (Appendix 1). Seven electronic databases will be searched (Scopus, Web of Science, EMBASE, MEDLINE, CINAHL, PsycINFO, and CENTRAL). Relevant search terms related to thinking style, the Rational-Experiential Inventory, and cancer prevention will be used. Medical Subject Headings (MeSH) key search terms and their derivatives will be utilised.

An initial limited search of EMBASE and Medline will be undertaken to identify key articles relevant to thinking styles in the context of cancer prevention. This approach will help to inform the development of a comprehensive search strategy, ensuring relevant studies are effectively captured and included. The keywords and index terms extracted from these articles will inform the development of a refined and comprehensive search strategy. Example search terms include “Rational experiential inventory” OR “need for cognition” OR “faith in intuition” OR “information processing style” OR “intuitive thinking” OR “deliberative thinking” OR “REI-40” OR “REI-31”.This strategy will then be reviewed and adapted for use across all target databases.

3.3. Data management and screening

Covidence software will be utilised to manage the systematic review process, including importing and deduplicating references, title and abstract screening, full-text screening, data extraction, and quality appraisal (risk of bias assessment). During the title and abstract screening phase, reviewers will pilot the eligibility criteria for study selection on ten titles and abstracts to test consistency, making and recording any refinements to the inclusion and exclusion criteria. Two reviewers will independently screen titles and abstracts. In cases of disagreement, a third reviewer (NC) will be consulted. The same process will be applied to full-text screening, with reasons for exclusion recorded. In cases of multiple publications reported from the same study, these reports will be collated and treated as a single study.

Data extraction

Two independent reviewers will perform data extraction and risk of bias assessment. A standardised data extraction template will be designed to capture relevant information. Study characteristics will include: title, authors, year, country, cancer prevention target, the thinking style measure used (REI or NFC or FI) and details of the study population (sample size, age range, sex distribution, and other relevant demographic characteristics) ( Table 2). Study outcomes will include: reported association between thinking style measures and cancer prevention behaviours, and any differences in thinking style across sociodemographic groups, particularly as they relate to cancer prevention domains ( Table 2). Additional information will be sought from study investigators if the required information is unclear or unavailable in the study publications.

Table 2. Example data extraction form.

Category	Data item	Type of data
General study information	Title	Title of the study
	Publication year	Year of publication (yyyy)
	Lead author	Lead author (first name, last name)
	Journal name	Full official journal title
	Country	Country where the study was conducted
	Aim of the study	Aim of the study
	Theoretical framework	Theoretical or conceptual framework used
Cancer prevention behaviour	Prevention behaviour outcomes	Outcomes of cancer prevention behaviour investigated (e.g. Adherence, Uptake, Intervention/willingness)
	Cancer prevention behaviours	Behaviour within the 14 ECAC recommendations investigated (smoking, second-hand smoke, weight management, physical activity & sedentary behaviour reduction, dietary patterns, alcohol avoidance, breastfeeding, sun protection, occupational carcinogen exposure, radon mitigation, air pollution, infection-related prevention, appropriate/limited hormone replacement therapy, participation in cancer screening, N/A if unknown
	Cancer screening details (if applicable)	For participation in organised cancer screening: type of cancer, programme type, kind of screening test, screening interval
Thinking style measures	Thinking style constructs and measures	Constructs used (NFC, FI, or REI, or selected items), specify the measure and psychometric properties + citation
Study design and methods	Study design	Overall study design
	Intervention characteristics (if interventional)	Rationale/theory/goal of intervention elements, physical/informational materials used, modes of delivery, whether personalised/titrated/adapted, intervention adherence if assessed
	Study setting	Setting where the study was conducted
	Study length	Study length
	Recruitment and eligibility	Recruitment methods, eligible criteria, exclusion criteria
	Data collection	Data collection methods
Population characteristics	Sample size	Total number of participants (response rate if reported), total number analysed
Population characteristics	Participant characteristics	Age, gender, marital status, ethnicity, education, income, employment/occupation, medical insurance, geographic disparities, comorbidities, other disadvantaged characteristics
Analysis and results	Hypothesis	Study hypothesis related to thinking style(s)
	Exposures and outcomes	Study exposure(s), study’s primary/secondary outcome(s)
	Role of thinking style	Role thinking style plays in the causal pathway
	Associations with prevention behaviours	Associations between thinking style and cancer prevention behaviours
	Associations with sociodemographic	Association between thinking styles and sociodemographic factors
	Statistical methods	Statistical methods used to explore relationships (e.g. regression, correlation)
	Effect measures and direction/size	Effect measures for each relevant association (e.g. odds ratio, beta coefficient; point estimate, 95% CI/SE, p-value, sample size per group); direction and size of effect for thinking style measure(s)
	Confounding adjustment	Adjustment for confounding factors
	Key results and limitations	Summary of key results (copied and pasted), limitations noted by authors (copied and pasted)

Risk of bias assessment (Appendix 3)

Risk of bias for non-randomised studies of interventions will be assessed using the Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I)³⁹ tool, which includes assessment of bias in seven domains including (i) confounding, (ii) selection of participants, (iii) classification of interventions, (iv) departures from intended interventions, (v) missing data, (vi) measurement of outcomes, and (vii) selection of reported results.

The Risk of Bias 2 (RoB 2) tool will be utilised for randomised studies of interventions and includes assessment across five domains: (i) randomisation process, (ii) deviation from intended intervention, (iii) missing outcome data, (iv) measurement of outcomes, and (v) selection of the reported results, with a final “overall risk of bias” judgment. For observational studies not involving an intervention, risk of bias will be assessed by the Newcastle-Ottawa Scale, evaluating bias related to (i) the selection of participants, (ii) the comparability of study groups, and (iii) the assessment of outcomes.

3.4. Collating and summarising the findings

A narrative synthesis of the data will be conducted based on: (i) thinking style profiles across populations using REI, FI, or NFC measures and (ii) the relationship between thinking styles and cancer prevention behaviours across populations. Extracted data from included studies will be reported in tabular formats. Descriptive statistics will be reported, including frequencies and percentages for demographic and thinking style factors. Reporting of potential moderators and measures of associations, effect sizes or any interventions reported within studies will be collated. Meta-analysis will be conducted if appropriate, where there are sufficient studies (at least 5) and will use fixed-effect models when heterogeneity is negligible and random-effects models if there is significant heterogeneity. Heterogeneity will be evaluated by Cochran’s Q test (95% CI) and I² statistic, with I² > 50% indicating significant heterogeneity. Pooled effect estimates will be presented with 95% confidence intervals. Subgroup analyses will be performed to explore differences in thinking styles based on sociodemographic factors. Sensitivity analyses and a funnel plot will be performed to assess publication bias.

4. Conclusion

The systematic review will address the gap in evidence regarding the relationship between dual processing thinking styles (measured by REI, FI and NFC) and cancer prevention. By providing an international synthesis of thinking style profiles and variations across sociodemographic groups, the outcomes of this systematic review will offer insights for cancer prevention intervention development, particularly within the cancer screening landscape, ultimately promoting health equity and strengthening cancer prevention efforts.

Data availability statement

Underlying data

No data are associated with this article.

Extended data

Open Science Framework Repository - The Role of Thinking Styles in Cancer Prevention Behaviour: A Systematic Review Protocol. DOI: 10.17605/OSF.IO/NKYGF.⁴⁰

This OSF project contains the following extended data:

(1) TS_Appendices.docx
(2) PRIMSA-P Checklist

Data are available under the terms of the Creative Commons Zero v1.0 Universal License.

Acknowledgement

The authors acknowledge Killian Walsh, RCSI information specialist, for his expert support in developing, refining, and executing the systematic search strategy across databases.

Reference

1. Bray F, Laversanne M, Sung H, et al.: Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2024 May; 74(3): 229–263. PubMed Abstract | Publisher Full Text
2. Goddard KAB, Feuer EJ, Mandelblatt JS, et al.: Estimation of Cancer Deaths Averted From Prevention, Screening, and Treatment Efforts, 1975-2020. JAMA Oncol. 2025 Feb 1; 11(2): 162–167. PubMed Abstract | Publisher Full Text | Free Full Text
3. OECD, European Commission: EU Country Cancer Profiles Synthesis Report 2025. OECD Publishing; 2025. (EU Country Cancer Profiles). Publisher Full Text
4. Espina C, Ritchie D, Riboli E, et al.: European Code Against Cancer 5th edition: 14 ways you can help prevent cancer. Lancet Reg Health - Eur. 2026 Apr; 63: 101592. PubMed Abstract | Publisher Full Text
5. Mottram R, Knerr WL, Gallacher D, et al.: Factors associated with attendance at screening for breast cancer: a systematic review and meta-analysis. BMJ Open. 2021 Nov; 11(11): e046660. Publisher Full Text
6. Dickson JL, Hall H, Horst C, et al.: Uptake of invitations to a lung health check offering low-dose CT lung cancer screening among an ethnically and socioeconomically diverse population at risk of lung cancer in the UK (SUMMIT): a prospective, longitudinal cohort study. Lancet Public Health. 2023 Feb; 8(2): e130–e140. PubMed Abstract | Publisher Full Text | Free Full Text
7. Perry N, Broeders M, de Wolf C , et al.: Executive summary. European guidelines for quality assurance in breast cancer screening and diagnosis. Fourth edition, Supplements. Luxembourg: European Commission, Office for Official Publications of the European Union; 2013; pp. XIV–XX.
8. Cardoso R, Guo F, Heisser T, et al.: Colorectal cancer incidence, mortality, and stage distribution in European countries in the colorectal cancer screening era: an international population-based study. Lancet Oncol. 2021 Jul; 22(7): 1002–13. Publisher Full Text
9. Ola I, Cardoso R, Hoffmeister M, et al.: Utilization of colorectal cancer screening tests across European countries: a cross-sectional analysis of the European health interview survey 2018–2020. Lancet Reg Health - Eur. 2024 Jun; 41: 100920. PubMed Abstract | Publisher Full Text | Free Full Text
10. Mulhem E, Sidahmed E, Xing Y, et al.: Disparities in Lung Cancer Screening: Demographic and Socioeconomic Influences. AJPM Focus. 2025 Dec; 4(6): 100428. PubMed Abstract | Publisher Full Text | Free Full Text
11. Clarke N, McNamara D, Kearney PM, et al.: The role of area-level deprivation and gender in participation in population-based faecal immunochemical test (FIT) colorectal cancer screening. Prev. Med. 2016 Dec; 93: 198–203. Publisher Full Text
12. De Klerk C, Gupta S, Dekker E, et al.: Socioeconomic and ethnic inequities within organised colorectal cancer screening programmes worldwide. Gut. 2017 Jan 10; 67: gutjnl-2016-313311. Publisher Full Text
13. Bricca A, Swithenbank Z, Scott N, et al.: Predictors of recruitment and retention in randomized controlled trials of behavioural smoking cessation interventions: a systematic review and meta-regression analysis. Addiction. 2022 Feb; 117(2): 299–311. PubMed Abstract | Publisher Full Text
14. Vangeli E, Stapleton J, Smit ES, et al.: Predictors of attempts to stop smoking and their success in adult general population samples: a systematic review. Addiction. 2011 Dec; 106(12): 2110–2121. PubMed Abstract | Publisher Full Text
15. Hiscock R, Bauld L, Amos A, et al.: Socioeconomic status and smoking: a review. Ann. N. Y. Acad. Sci. 2012 Feb; 1248(1): 107–123. Publisher Full Text
16. Sacre A, Bambra C, Wildman JM, et al.: Socioeconomic inequalities in vaccine uptake: A global umbrella review. Brunelli L, editor. PLoS One. 2023 Dec 13; 18(12): e0294688. Publisher Full Text
17. O’Flaherty M, Lloyd-Williams F, Capewell S, et al.: Modelling tool to support decision-making in the NHS Health Check programme: workshops, systematic review and co-production with users. Health Technol. Assess. 2021 May; 25(35): 1–234. PubMed Abstract | Publisher Full Text | Free Full Text
18. Jepson RG, Harris FM, Platt S, et al.: The effectiveness of interventions to change six health behaviours: a review of reviews. BMC Public Health. 2010 Dec; 10(1): 538. PubMed Abstract | Publisher Full Text | Free Full Text
19. Lindson N, Pritchard G, Hong B, et al.: Strategies to improve smoking cessation rates in primary care. Cochrane Tobacco Addiction Group, editor. Cochrane Database Syst. Rev. 2021 Sep 6; 2021(9). Publisher Full Text
20. O’Cathain A, Croot L, Duncan E, et al.: Guidance on how to develop complex interventions to improve health and healthcare. BMJ Open. 2019 Aug; 9(8): e029954. Publisher Full Text
21. Ryan RM, Deci EL: Self-determination theory and the facilitation of intrinsic motivation. Am. Psychol. 2000; 55(1): 68–78. Publisher Full Text
22. Lazarus RS: Progress on a cognitive-motivational-relational theory of emotion. Am. Psychol. 1991; 46(8): 819–834. PubMed Abstract | Publisher Full Text
23. Le Bonniec A, Meade O, Fredrix M, et al.: Exploring non-participation in colorectal cancer screening: A systematic review of qualitative studies. Soc Sci Med. 2023 Jul; 329: 116022. Publisher Full Text
24. Dressler J, Johnsen AT, Madsen LJ, et al.: Factors affecting patient adherence to publicly funded colorectal cancer screening programmes: a systematic review. Public Health. 2021 Jan; 190: 67–74. Publisher Full Text
25. Mascara M, Constantinou C: Global perceptions of women on breast cancer and barriers to screening. Curr. Oncol. Rep. 2021 Jul; 23(7): 74. PubMed Abstract | Publisher Full Text
26. Clarke N, Kearney PM, Gallagher P, et al.: Negative emotions and cancer fatalism are independently associated with uptake of Faecal Immunochemical Test-based colorectal cancer screening: Results from a population-based study. Prev. Med. 2021 Apr; 145: 106430. Publisher Full Text
27. Clarke N, Hayes L, McQueen A, et al.: The role of defensive information processing in population-based colorectal cancer screening uptake. Cancer. 2023 Apr 15; 129(8): 1253–1260. PubMed Abstract | Publisher Full Text
28. Martinelli M, Veltri GA: Do cognitive styles affect vaccine hesitancy? A dual-process cognitive framework for vaccine hesitancy and the role of risk perceptions. Soc Sci Med. 2021 Nov; 289: 114403. PubMed Abstract | Publisher Full Text
29. Pacini R, Epstein S: The relation of rational and experiential information processing styles to personality, basic beliefs, and the ratio-bias phenomenon. J. Pers. Soc. Psychol. 1999; 76(6): 972–987. Publisher Full Text
30. Epstein S, Pacini R, Denes-Raj V, et al.: Individual Differences in Intuitive-Experiential and Analytical-Rational Thinking Styles. J. Pers. Soc. Psychol. 1996; 71(2): 390–405. PubMed Abstract | Publisher Full Text
31. Zeigler-Hill V, Shackelford TK: Encyclopedia of Personality and Individual Differences. Cham: Springer International Publishing; 2020. Publisher Full Text
32. Cacioppo JT, Petty RE: The need for cognition. J. Pers. Soc. Psychol. 1982 Jan; 42(1): 116–131. Publisher Full Text
33. Epstein S: The Implications of Cognitive-experiential Self-theory for Research in Social Psychology and Personality. J. Theory Soc. Behav. 1985 Oct; 15(3): 283–310. Publisher Full Text
34. Weiner IB, Tennen HA, Suls JM, editors. Handbook of Psychology. Personality and Social Psychology. Hoboken, New Jersey: John Wiley & Sons, Inc.; 2nd Edition2012.
35. Williams-Piehota P, Schneider TR, Pizarro J, et al.: Matching Health Messages to Information-Processing Styles: Need for Cognition and Mammography Utilization. Health Commun. 2003 Oct; 15(4): 375–392. PubMed Abstract | Publisher Full Text
36. McGuiness CE, Turnbull D, Wilson C, et al.: Thinking Style as a Predictor of Men’s Participation in Cancer Screening. Am. J. Mens Health. 2017 Mar; 11(2): 318–329. PubMed Abstract | Publisher Full Text | Free Full Text
37. Schindler J, Schindler S, Pfattheicher S: The role of intuition in vaccination attitudes. J. Health Psychol. 2021 Dec; 26(14): 2950–2957. PubMed Abstract | Publisher Full Text
38. Shamseer L, Moher D, Clarke M, et al.: Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015 Jan 2; 349(jan02 1): g7647–g7647. PubMed Abstract | Publisher Full Text
39. Sterne JA, Hernán MA, Reeves BC, et al.: ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016 Oct 12; i4919. Publisher Full Text
40. Ngo U, Ahmed R, McQueen A, et al.: The Role of Thinking Styles in Cancer Prevention Behaviour: A Systematic Review Protocol.2026. Publisher Full Text

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