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.
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