FormalPara Key Points

  • Yarn for Life is the first national cancer awareness campaign developed by and for Aboriginal and Torres Strait Islander people. It aims to reduce the impact of cancer within Aboriginal and Torres Strait Islander communities by encouraging conversations about cancer.

  • An evaluation of Yarn for Life with the target audience showed that the campaign messaging is engaging and easy to understand, and encourages people to talk about cancer with their family and communities.

  • As the Yarn for Life campaign builds, it must innovate to expand its reach among Aboriginal and Torres Strait Islander peoples.

While Australia’s cancer survival rates are among the best in the world, Aboriginal and Torres Strait Islander people experience significant disparities in cancer outcomes.

Evidence review and consultation with Aboriginal and Torres Strait Islander people during the development of the National Aboriginal and Torres Strait Islander Cancer Framework (the Framework) confirmed that a widespread lack of knowledge about cancer is a significant barrier to improving cancer outcomes for Aboriginal and Torres Strait Islander people [1]. This informed Priority 1 of the Framework: “Improve knowledge, attitudes, and understanding of cancer by individuals, families, carers, and community members (across the continuum).” Enablers of this priority include:

  • Using evidence-based public-awareness programs and health-promotion strategies that specifically address the concerns and needs of Aboriginal and Torres Strait Islander people.

  • Ensuring that information is available and accessible to Aboriginal and Torres Strait Islander people across the cancer continuum, in formats and language(s) that are culturally appropriate.

  • Ensuring community involvement throughout the development of public-awareness and health-promotion campaigns.

  • Enhancing community capacity and engaging and supporting key community members to promote cancer literacy [1].

What Was Done

Developing the Campaign

As the national cancer control agency, Cancer Australia developed a communication campaign in line with the Framework to reduce the impact of cancer within Aboriginal and Torres Strait Islander communities. An Indigenous-owned and Indigenous-operated creative agency (Carbon Creative) was engaged to develop and implement culturally appropriate communications through a multichannel strategy.

To successfully define and articulate key messages, an evidence-based campaign schema was developed based on three content pillars that guided campaign development:

  • Myth busting and education.

  • Fatalism.

  • Facing fears.

The campaign aims to address the shame and stigma associated with cancer by changing how Aboriginal and Torres Strait Islander people think about cancer. Key objectives of the campaign, identified by Cancer Australia and Carbon Creative, include:

  • Increasing awareness and understanding of cancer among Aboriginal and Torres Strait Islander people.

  • Normalizing conversations about cancer.

  • Emphasizing the importance of early detection.

As part of the creative concept development, preliminary qualitative research was conducted to determine how the campaign would be received by the target audience. A survey of Aboriginal and Torres Strait Islander people was conducted to determine the target audience’s views on the creative aspects of the campaign, including its proposed look and feel, its slogan “Yarn for Life,” the call to action “There’s no shame in cancer,” and its imagery. Learnings from this research informed the final creative concept. The creative concept was well received, and recommendations to amend the tagline to “It’s OK to talk about cancer” were accepted and progressed.

Yarn for Life

Yarn for Life is the first national cancer awareness campaign developed by and for Aboriginal and Torres Strait Islander people [2]. It aims to reduce the impact of cancer within Aboriginal and Torres Strait Islander communities by encouraging and normalizing conversations about cancer and promoting the importance of early detection and timely referral (Fig. 20.1).

Fig. 20.1
A screenshot of the landing page of Yarn for Life. It has a photo of 2 women holding each other with a text near reads, Yarn for Life, it's ok to talk about cancer.

Yarn for Life website landing page

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Yarn for Life delivers the central message “It’s OK to talk about cancer” by sharing personal stories of courage and survivorship from Aboriginal and Torres Strait Islander people. The stories are provided by three people and their respective loved ones sharing their cancer journeys. Two prominent Indigenous leaders, Leila Gurruwiwi and Charlie King, also speak to the key messages of the campaign with a call to action for the audience. These stories are shared through a suite of resources including videos, animations, audio grabs, and posters.

Implementation was completed using a multichannel communication strategy, including a website landing page, paid social media, radio, Spotify, YouTube, and television. Videos played on rotation across the National Aboriginal Health Television network, which is shown in the waiting rooms of Aboriginal Medical Services (AMSs). Key messages were translated and shared on radio as well as on the Yarn for Life website. The communication strategy is implemented annually for six to 12 weeks. Since commencing in 2019, the Yarn for Life campaign has had five rounds of implementation (Fig. 20.2).

Fig. 20.2
Two posters of the Yarn for Life. Left, a photo of a man with the text reads, yarning about cancer can save lives. Right, a photo of a woman with the text reads, it can be hard for us women to yarn about cancer.

Yarn for Life posters featuring Indigenous leaders Charlie King (left) and Leila Gurruwiwi (right)

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The Yarn for Life campaign is intended for all Aboriginal and Torres Strait Islander communities; however, the campaign resources have been delivered at higher volumes in areas with high Aboriginal and Torres Strait Islander populations, particularly those areas most related to the origins of the people featured in the campaign’s resources (greater metropolitan Sydney, South Australia, Queensland, and the Northern Territory).

Outcomes

In December 2020, approximately one year into the campaign, qualitative research was undertaken to explore attitudes, knowledge, and understanding around cancer in communities from remote locations of Australia. Phone and text surveys were undertaken with representatives from the target audience, and positive feedback was received from participants on the messaging and campaign strategy. Key insights included that many remote communities receive their health information from their local AMSs. Accordingly, a key recommendation was to engage remote AMSs through the Australian Aboriginal Health Television network, which delivers culturally relevant health and wellbeing messages via more than 300 screens across AMSs nationally. This was incorporated into further iterations of the campaign.

A comprehensive evaluation of Yarn for Life was undertaken in June 2021. Cancer Australia engaged an external Indigenous consultant for the evaluation. Ethical approval was granted by the Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS) Research Ethics Committee in March 2021. The evaluation used pre-campaign and post-campaign online surveys to measure changes in awareness, attitudes, intentions, and behaviors. A post-campaign face-to-face survey was also used, providing perspectives from Aboriginal and Torres Strait Islander people in regional and remote Australia. The subject sampling for the evaluation included an Australia-wide opt-in recruitment round through social media for the online survey, and three convenience samples in Darwin, Alice Springs, and the Torres Strait Islands for the face-to-face survey.

The evaluation results showed that the majority of respondents found the content of the campaign “easy to understand” (97–100%) and endorsed its key messages. The most prevalent message respondents took from the campaign was “it’s OK to talk/yarn about cancer.” Another highly positive result was that around 8 in 10 (67–87%) respondents agreed that the campaign resources prompted them to think about talking to family and friends about cancer. Further, survey results suggested the campaign improved respondents’ knowledge about who to speak to about cancer, with 83% of those who had seen the campaign indicating they knew where to go, compared to 69% of those who had not seen the campaign.

Reasonable levels of campaign awareness were recorded, with one in four (26%) online respondents and one in five (19%) face-to-face respondents recognizing de-branded campaign resources. Radio advertisements had higher levels of prompted recognition compared to other communication channels in metropolitan areas, while recognition in regional and remote areas was mainly driven by television and video advertisements. One barrier to radio advertisement recall in remote areas was the audio not being in an Indigenous language. Resources featuring prominent Indigenous leaders were deemed to be the most effective of the campaign.

Learnings

The Yarn for Life campaign is competing against many cancer-related advertisements targeting a similar audience. This was evident in the evaluation, with very few survey respondents agreeing the campaign “told you something new.” This highlighted the need to focus on audience engagement through refreshing campaign resources and communication strategies.

Communication should be tailored for different audience members. For example, audio grabs have now been recorded in 14 different languages for in-language radio advertisements. In the future, content with prominent Indigenous leaders could be expanded and new local champions could be engaged to increase the reach of the campaign.

Yarn for Life demonstrates the value and necessity of Indigenous people leading and partnering in designing and implementing communication campaigns that are for them. As the campaign builds, innovation is needed to expand the reach of the campaign and ensure its longevity. This will only be achieved through leadership from and partnership with Aboriginal and Torres Strait Islander people.