Abstract
Objective: The primary goal of our research was to empirically test whether utilizing a narrative format might produce a greater and longer lasting impact on health related knowledge, attitudes and prevention behavior compared to more traditional non-narrative format of conveying health information. We did so by undertaking a quantitative randomized trial comparing the relative efficacy of a fictional narrative film (Tamale Lesson) to a more traditional nonfiction film (It's Time) in conveying the same information regarding cervical prevention (via HPV vaccination), detection (via Pap testing and newer tests) and treatment.
Method: A random digit dial procedure was used to survey the cervical cancer-related knowledge, attitudes and behavior of Non-Hispanic White, Mexican-American, and African-American women between the ages of 25-45 living in Los Angeles. Participants (N=704) were then randomly assigned to receive either a narrative or non-narrative film containing the same information about how cervical cancer can be prevented or detected; and re-contacted two weeks (posttest survey) and six months later (follow-up survey).
Results: At posttest both films produced a significant increase in cervical cancer-related knowledge and attitudes, but these effects were significantly higher for the narrative film. At six months, viewers of both films retained greater than baseline knowledge and more positive attitudes toward Pap tests, but women who saw the narrative were significantly more likely to have had a Pap test or scheduled one. The narrative was particularly effective for Mexican-American women, completely eliminating cervical cancer screening disparities found at baseline. Mexican American women in our sample went from having the lowest overall levels of screening at pretest (32%) to the highest (83%) at the 6-month follow-up. This dramatic increase was not due to ethnicity alone, but to the fact that Mexican American women in our sample were more likely to identify with the characters in the narrative who engaged in the desired behavior and report becoming “transported” (Green, et. al, 2004) or engrossed while watching the narrative film.
Conclusion: To the extent that narrative can result in members of a target audience identifying with characters who model the desired behavior and becoming transported (a state known to produce less counter-arguing and suspension of disbelief), narratives may prove a useful tool for reducing health disparities. Pointers on how to design and test narrative materials will be included. While this study focuses on one particular health disparity, it is important to note that our results have much broader implications for the use of narrative in health communication more generally.
Citation Format: Sheila T. Murphy. Telling stories, saving lives: Creating narrative health messages to reduce cancer health disparities. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr IA04.
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