Transforming Cancer Knowledge, Attitudes and Behavior through Narrative

描述（由申请人提供）：拟议研究的主要目的是挑战基本假设，即传统的直接叙述事实是传达健康相关信息的最佳方式。第1年和第2年的重点是通过分析10个最受欢迎的黄金时段电视节目中癌症预防的频率和类型来了解现有的癌症描述。为了评估这些黄金时段的描绘每周对1000万至2000万观众的影响，我们将与好莱坞，健康与社会和电视网络合作，以确定即将到来的涉及乳腺癌和宫颈癌的剧集。通过测量这些剧集播出前后观众与癌症相关的知识、态度和行为的任何变化，我们可以确定使故事或叙事或多或少有效的关键因素。在第三年，我们实证测试是否利用叙事格式产生更大和更持久的影响癌症知识，态度和预防行为。400名年龄在25-65岁之间，没有既往癌症史的女性将被呈现一个动画故事，涉及一名被诊断患有宫颈癌的年轻女性（实验性叙事条件）。同样的事实信息将在非叙述控制条件下呈现给另外400名妇女。因为我们也质疑“一刀切”的信息策略的假设，我们的样本将在四个种族群体中平均分配-非洲裔美国人，欧洲裔美国人，韩裔美国人和墨西哥裔美国人-所有这些人都有乳腺癌或卵巢癌的高风险。除了文化差异，我们预测，叙事可能是特别有效的文化与强大的口述历史，为最近的移民，为老一代，和那些识字率低。我们将通过使用定性技术，如焦点小组和咨询医学人类学家，进一步了解不同年龄，种族，文化适应和教育水平的妇女如何理解癌症，其原因，预防和治疗，为这些发现增加背景和深度。在第四年，我们研究沟通方式的影响，以确定哪些沟通渠道或渠道可能会产生最强和最持久的信息保留和动机的变化。更具体地说，我们将进行一项现场实验，其中800名女性的新鲜样本将被随机分配到相同的癌症叙述中，但200名（每个种族50人）将以印刷形式接触叙述，200人以音频形式接触叙述200个以视听格式（类似于电视或YouTube），以及200个以需要来自个人的响应的交互式格式（类似于视频游戏）。这种设计将使我们能够测试叙事的有效性是否会随着渠道的功能而变化，以及模态和关键人口因素（如世代，文化适应水平和教育）之间是否存在相互作用。总之，这些方法工具中的每一个都为如何向日益多样化的受众最好地传达健康信息的整体难题提供了重要的一部分。

DESCRIPTION (provided by applicant): The primary purpose of the proposed research is to challenge the underlying assumption that the traditional straightforward recitation of the facts is the optimal way to convey health-related information. Years 1 and 2 focus on understanding existing cancer portrayals by analyzing the frequency and type of cancer depictions on the 10 most popular primetime television programs. To assess the impact these primetime portrayals have on between 10 to 20 million viewers each week, we will be working with Hollywood, Health and Society and the television networks to identify upcoming episodes involving breast and cervical cancer. By measuring any change in viewers' cancer-related knowledge, attitudes and behavior before and after these episodes air, we can determine the key elements that make a story or narrative more or less effective. In Year 3, we empirically test whether utilizing a narrative format produces a greater and longer lasting impact on cancer knowledge, attitudes and prevention behavior. Four hundred females between the ages of 25-65 with no pre-existing cancer history will be presented with an animated narrative involving a young woman who is diagnosed with cervical cancer (the experimental narrative condition). The same factual information will be presented to another 400 women in the non-narrative control condition. Because we also question the assumption of a "one- size-fits-all" message strategy our sample will be equally divided among four ethnic groups - African Americans, European Americans, Korean Americans and Mexican Americans - all of whom are at elevated risk for breast or ovarian cancer. In addition to cultural differences, we predict that narratives may be particularly effective for cultures with a strong oral history, for recent immigrants, for older generations, and for those with low literacy. We will add context and depth to these findings by using qualitative techniques such as focus groups and consulting with medical anthropologists to further understand how women of different ages, ethnicities, acculturation and education levels understand cancer, its cause, prevention and treatment. In Year 4, we examine the effect of communication modality to determine which communication channel or channels might produce the strongest and longest lasting changes in information retention and motivation. More specifically, we will conduct a field experiment in which a fresh sample of 800 females will be randomly assigned to the same cancer narrative but 200 (50 of each ethnicity) will be exposed to the narrative in a print format, 200 in an audio format (similar to radio), 200 in an audiovisual format (similar to television or YouTube), and 200 in an interactive format requiring responses from the individual (similar to a videogame). This design will allow us to test whether the effectiveness of a narrative may vary as a function of channel and whether there is an interaction between modality and key demographic factors such as generation, level of acculturation and education. In sum, each of these methodological tools provides an important piece to the overall puzzle of how to best convey health information to increasingly diverse audiences.