Narrative versus Nonnarrative: The Role of Identification, Transportation and Emotion in Reducing Health Disparities

This research empirically tests whether using a fictional narrative produces a greater impact on health-related knowledge, attitudes, and behavioral intention than presenting the identical information in a more traditional, nonfiction, non-narrative format. European American, Mexican American, and African American women (N = 758) were surveyed before and after viewing either a narrative or non-narrative cervical cancer-related film. The narrative was more effective in increasing cervical cancer-related knowledge and attitudes. Moreover, in response to the narrative featuring Latinas, Mexican Americans were most transported, identified most with the characters, and experienced the strongest emotions. Regressions revealed that transportation, identification with specific characters, and emotion each contributed to shifts in knowledge, attitudes, and behavioral intentions. Thus, narrative formats may provide a valuable tool in reducing health disparities

The Importance of Interpersonal Discussion and Self-Efficacy in Knowledge, Attitude, and Practice Models

This study contributes to the theoretical discussions about the influence of education-entertainment programming on consumers of the genre. Data from the end-line evaluation of an EE program produced by the BBC World Service Trust in India, Jasoos (Detective) Vijay, is used. The analysis focused on 834 sexually active young men, the key demographic target audience for the program. Using structural equation modeling techniques, an initial knowledge, attitudes, and practices model is examined. Adding self-efficacy and interpersonal discussion improve this model. Not only is interpersonal discussion important, but the target others with whom that discussion occurs are also important for predicting behavioral change. Implications for EE theory and programs are explored

Telling Stories, Saving Lives: Creating Narrative Health Messages

Increasingly, health communication practitioners are exploring the use of narrative storytelling to convey health information. For this study, a narrative film was produced to provide information about the Human Papillomavirus (HPV) and cervical cancer prevention. The storyline centered on Lupita, a young woman recently diagnosed with HPV who informs her family about HPV and the availability of the HPV vaccine for her younger sister. The objective was to examine the roles of identification with characters and narrative involvement (made up of three dimensions: involvement, perceived relevance, and immersion) on perceived response efficacy, perceived severity, and perceived susceptibility to HPV and behavior (discussing the HPV vaccine with a health care provider). A random sample of 450 European American, Mexican American, and African American women between the ages of 25 to 45 living in the Los Angeles area was surveyed by phone before, two weeks after, and six months after viewing the film. The more relevant women found the narrative to their own lives at two weeks, the higher they perceived the severity of the virus and the perceived response efficacy of the vaccine. Also at two weeks, identifying with characters was positively associated with perceived susceptibility to HPV but negatively associated with perceived severity. At six months, identification with specific characters was significantly associated with perceived threat and behavior. These findings suggest that different aspects of narrative health messages should be manipulated depending on the specific beliefs and behaviors being targeted. Implications for narrative message design are discussed

Information Scanning and Vaccine Safety Concerns among African American, Mexican American, and Non-Hispanic White Women

Objective A significant number of parents delay or refuse vaccinating their children. Incidental exposure to vaccine information (i.e., scanned information) may be an important contributor to anti-vaccine sentiment. This study examines the association between scanned information, trust in health information sources and vaccine safety concerns among African American, Mexican American, and non-Hispanic White women. Methods Women (N=761) in Los Angeles County were sampled via random digit dial and surveyed regarding use of and trust in health information resources and vaccine safety concerns. Results Analyses indicate that the sources of information associated with vaccine safety concerns varied by ethnicity. Each ethnic group exhibited different patterns of association between trust in health information resources and vaccine safety concerns. Conclusions Information scanning is associated with beliefs about vaccine safety, which may lead parents to refuse or delay vaccinating their children. These relationships vary by ethnicity. Practice Implications These findings help inform practitioners and policy makers about communication factors that influence vaccine safety concerns. Knowing these sources of information will equip practitioners to better identify women who may have been exposed to anti-vaccine messages and counter these beliefs with effective, vaccine-promoting messages via the most relevant information sources

The Transformative Power of Narrative as a Behavioral Change Communication Tool to Reduce Health Disparities in Cervical Cancer among Latinas: Global Implications

Cervical cancer is the third most common type of cancer in women globally. Latinas carry a disproportionate burden of this disease. In the United States, when compared with non-Hispanic Whites (NHW), Latinas endure much higher incidence rates (13.86 vs. 7.70 per 100,000) with mortality rates 1.5 times greater than for non-Hispanic white women . In order to address this disparity, a multidisciplinary team engaged in a transformative study to test if narrative, developed in culturally specific ways as a behavioral change communication tool, works better than non-narrative in increasing knowledge and changing attitudes and behaviors and, if so, why. This case study presents findings from Tamale Lesson, an award winning video that promotes cervical cancer screening via Pap test and prevention (via use of the Human Papillomavirus vaccine (HPV)). Tamale Lesson was compared with a non-narrative film, It’s Time, to determine if the narrative produced a stronger impact between pre-test to two weeks later and six months after viewing the film. The films are each 11 minutes in length and contain the same facts. Tamale Lesson depicts a Mexican American family’s preparation for the youngest daughter’s 15th birthday as the narrative vehicle. Findings reveal a high level of acceptance of Tamale Lesson, and significant reductions in cervical cancer disparities among Mexican American women. This case study highlights the benefits of creating a culturally competent narrative intervention, and underscores the powerful potential of narrative/storytelling in eliminating disparities worldwide

Predictors of HPV Knowledge and HPV Vaccine Awareness Among Women in Panama City, Panama

In 2008, Panama became the first country in Latin America to offer the Human Papilloma Virus (HPV) vaccine at no cost to 10‐year‐old girls as part of its National Immunization Program. Vaccine completion rates remain suboptimal, and knowledge is limited regarding public perceptions of the HPV vaccine in Panama. A cross‐sectional survey of 333 Panamanian women aged 18–65 was conducted in Panama City, Panama. Although 93 percent of respondents had heard of HPV, only 59.8 percent had heard of the HPV vaccine. Acceptability of HPV vaccination of daughters was high (95 percent). In multivariate analyses, HPV vaccine awareness was associated with age and education, but not with income, Internet use as preferred source of health information, indigenous race, or marital status. Additionally, after controlling for age, education, income, race, and Internet use, women who completed a pap test in the past 36 months were 3.12 times more likely to have heard of the HPV vaccine when compared to those who had not (95%CI 1.04–9.34). Future efforts to educate Panamanian women about the HPV vaccine should include special attention to vulnerable populations, including those of younger age and limited education