What makes cancer survivor stories work? An empirical study among African American women
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Cancer survivors play a vital role in cancer control as messengers of hope and information, and advocates for prevention and screening. Understanding what makes survivor stories effective can enhance survivor-delivered programs and interventions.
By random assignment and using a cross-classified design, 200 African American women viewed videotaped stories (n = 300) from 36 African American breast cancer survivors. Analyses examined effects of story attributes (narrative quality, health message strength), participant characteristics (ways of knowing, experience with breast cancer) and identification with the survivor on women’s: (1) level of engagement in the story; (2) positive thoughts about the story; and, (3) remembering key messages about breast cancer and mammography in the story.
Participant characteristics were significant predictors of all three study outcomes, accounting for 27.8, 2.6 and 22.2% of their total variance, respectively. In comparison, the variability in these outcomes that could be attributed to differences in the stories was small (0.6, 1.1 and 2%, respectively). The effects of participant characteristics on level of engagement and positive thoughts were mediated by identification with the survivor.
The best predictor of a woman becoming engaged in a breast cancer survivor’s story and having positive thoughts about the story was whether she liked the survivor and viewed her as similar to herself (i.e., identification).
Implications for cancer survivors
Survivor stories may be most effective when audience members identify with the survivor. Finding key characteristics that can reliably match the two will advance cancer communication science and practice.
KeywordsCancer communication Health disparities Breast cancer Narrative communication
This study was supported by a grant from the National Cancer Institute’s Centers of Excellence in Cancer Communication Research program (CA-P50-95815). The authors thank JoAnne Banks Wallace and Shanti Parikh for assistance with formative research, Jean Freeman, Hollie Milam and Kim Vaughn for assistance capturing survivor stories, Dana Weston, Maria Hamtil-Hockenhull, Delores Dotson, Keri Jupka, Catina Scott, Kim Kennedy and Leslie Hinyard for indexing and coding survivor stories, Christine Dao and Kia Davis for administering the research protocol, and Sharon Homan, Qiang Fu, Melanie Green and Mike Slater for helping with research design and analytic methods. We are especially grateful to the 49 breast cancer survivors and family members who shared their stories, without whom this research would not be possible. The Murchison Tabernacle Cancer Support Group, Sistah Connection, The Breakfast Club, Inc., The Witness Project and Mustard Seed were key partners in identifying breast cancer survivors.
- 3.Rogers TF, Bauman LJ, Metzger L. An assessment of the Reach to Recovery program. CA: A Cancer Journal for Clinicians. 1985;35(2):116–24.Google Scholar
- 4.Eysenbach G. The impact of the Internet on cancer outcomes. CA: A Cancer Journal for Clinicians. 2003;53:356–71.Google Scholar
- 10.Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.Google Scholar
- 11.Kreuter MW, Green MC, Cappella JN, Slater MD, Wise ME, Storey D, et al. Narrative communication in cancer prevention and control: a framework to guide research and application. Annals Behav Med. 2007;33(3):221–35.Google Scholar
- 13.Bruner J. Actual minds, possible words. Massachusetts: Harvard University Press; 1986.Google Scholar
- 14.Hatcher J. The art and craft of playwriting. Cincinnati, OH: Storey; 1996.Google Scholar
- 15.Hicks ND. Screenwriting 101: The essence and craft of feature film writing. New York, NY: McNaughton and Guner; 1999.Google Scholar
- 17.O’Keefe DJ. Standpoint explicitness and persuasive effect: a meta-analytic review of the effects of varying conclusion articulation in persuasive messages. Argum Advocacy. 1997;34:1–12.Google Scholar
- 19.Janz NK, Champion VL, Strecher VJ. The health belief model. In: Glanz K, Lewis F, Rimer B, editors. Health behavior and health education. 3rd ed. San Francisco: Jossey-Bass; 2002. pp. 45–66.Google Scholar
- 22.Banks-Wallace J. Womanist ways of knowing: theoretical considerations for research with African American women. Adv Nurs Sci. 2000;22(3):33–5.Google Scholar
- 23.Collins P. (Ed.) (2000). Black feminist thought. 2nd ed. New York: Routledge.Google Scholar
- 24.Miller RS, Perlman D, Brehm SS. Intimate relationships. Boston: McGraw-Hill; 2007.Google Scholar
- 25.Cialdini RB, Sagarin BJ. Principles of interpersonal influence. In: Brock TC, Green MC, editors. Persuasion: psychological insights and perspectives. 2nd ed. Newbury Park, CA: Sage; 2005. pp. 143–69.Google Scholar
- 26.Hass RG. Effects of source characteristics on cognitive responses and persuasion. In: Petty RE, Ostrom TM, Brock TC, editors. Cognitive responses in persuasion. Hillsdale, NJ: Lawrence Erlbaum Associates; 1981. pp. 141–72.Google Scholar
- 27.Petty RE, Cacioppo JT, Strathman AJ, Priester JR. To think or not to think: exploring two routes to persuasion. In: Brock TC, Green MC, editors. Persuasion: psychological insights and perspectives. 2nd ed. Needham Heights, MA: Allyn & Bacon; 2005. pp. 81–116.Google Scholar
- 28.Wengraf T. Qualitative research interviewing: biographic narrative and semi-structured methods. London: Sage; 2001.Google Scholar
- 30.Eagly AH, Chaiken S. Attitude structure and function. In: Gilbert D, Fiske S, Lindzey G, editors. The handbook of social psychology. 4th ed. New York: McGraw-Hill; 1998. pp. 269–322.Google Scholar
- 31.Deshpande AD, Sanders-Thompson VL, Vaughn K, Kreuter MW (2007) Use of socio-cultural constructs in cancer research among African Americans: A review. Cancer Control (in press).Google Scholar
- 35.Cacioppo JT, Harkins SG. The nature of attitudes and cognitive responses and their relationship to behavior. In: Petty RE, Ostrom TM, Brock TC, editors. Cognitive responses in persuasion. Hillsdale, NJ: Lawrence Erlbaum Associates; 1981. pp. 31–4.Google Scholar
- 36.Petty RE, Wegner DT. Attitude change: Multiple roles for persuasion variables. In: Gilbert D, Fiske S, Lindzey G, editors. The handbook of social psychology. 4th ed. New York: McGraw-Hill; 1998. pp. 323–89.Google Scholar
- 38.Singer JD, Willett JB. Applied longitudinal data analysis. Oxford: Oxford University Press; 2003.Google Scholar
- 45.Kreuter MW, Strecher VJ, Glassman B. One size does not fit all: the case for tailoring print materials. Annals Behav Med. 1999;21(4):276–83.Google Scholar