Refining Entertainment Education for Cancer Literacy in African American Women

描述（由申请人提供）：美国缺乏健康素养是一个广泛而严重的健康威胁（1）。娱乐教育（EE）将健康信息嵌入娱乐叙事（2），并有望提高广大观众的健康素养。本研究将探讨操纵三个叙事元素的音频肥皂剧，纳入乳腺癌和结直肠癌筛查信息EE建议的影响。研究参与者将是50岁以上的非洲裔美国妇女，据报道，这些观众从肥皂剧中获得了健康信息（54），并建议对这些疾病进行筛查（6）。该研究将以运输/意象模型（4）为指导，该模型从理论上认为，只有当观众感到被带走或“运输”到叙事世界时，接触叙事才会改变健康行为及其决定因素。我们假设，肥皂剧听众的结果测量得分高于听专家访谈的对照组成员。在肥皂剧听众中，我们期望在以下情况下有更高水平的交通：（a）癌症筛查信息被嵌入涉及主要人物的中心情节中，而不是涉及次要人物的子情节中，（B）叙事是具有一贯严肃基调的戏剧，而不是喜剧，以及（c）剧情奖励角色被筛选为立即阴性的测试结果，而不是由于阳性而早期开始的最终成功的治疗结果。筛选结果当交通分数增加时，我们预测癌症识字率，其他心理社会筛查决定因素，寻求信息和筛查的意图以及实际信息寻求和筛查行为（如预约）的增加。形成性研究将指导各种版本的音频肥皂剧的开发，这些肥皂剧将包含乳房和结肠直肠筛查信息。然后进行两个随机实验。600名女性将在一个面对面的小组中每人听一个版本的肥皂剧。参与者将在接触录音带之前、之后和一个月后立即完成问卷。公共卫生相关性：与白人相比，非裔美国人的健康素养水平较低，非裔美国妇女在筛查率、晚期诊断和死亡方面存在乳腺癌和结直肠癌的负差异（8，9）。这项研究的长期目标是制定更有效的方法，向非裔美国妇女提供健康信息，并促进她们的健康素养。这种知识的公共卫生相关性在于它有可能减少大量少数群体人口的健康差距。

DESCRIPTION (provided by applicant): The lack of health literacy in the United States represents a widespread and serious health threat (1). Entertainment Education (EE) embeds health information into entertaining narratives (2) and holds promise for increasing health literacy among large audiences. This study will investigate the effects of manipulating three narrative elements in audio soap operas that incorporate breast and colorectal cancer screening messages as EE recommends. Study participants will be African American women over 50 years old, an audience that has reported getting health information from soap operas (54) and for whom screening for these diseases is recommended (6). The research will be guided by the Transportation/Imagery Model (4) which theorizes that exposure to narratives changes health behavior and its determinants only when an audience member feels carried away or "transported" into a narrative world. We hypothesize that there will be higher scores on outcome measures among soap opera listeners than among members of a control group who listen to an expert interview. Among soap opera listeners, we expect higher levels of transportation when: (a) cancer screening messages are embeded in a central plot that involves main characters rather than in a subplot that deals with minor characters, (b) the narrative is a drama with a consistently serious tone instead of a comedy, and (c) the plot rewards the character for being screened with an immediately negative test result instead of with an eventually successful outcome of treatment that began early because of a positive screening result. When transportation scores increase, we predict increases in cancer literacy, other psychosocial screening determinants, intentions to seek information and screening, and actual information-seeking and screening behavior such as appointment- making. Formative research will guide the development of various versions of audio soap operas that will incorporate breast and colorectal screening messages. Then two randomized experiments will be conducted. Six hundred women will each hear one version of a soap opera in a small, face-to-face group. Participants will complete questionnaires immediately before and after exposure to the audiotape and one month later. PUBLIC HEALTH RELEVANCE: African Americans have lower levels of health literacy compared to whites and African American women suffer negative breast and colorectal cancer disparities with regard to screening rates, late-stage diagnosis and death (8,9). The long-term objective of this study is to develop more effective ways to deliver health messages to and promote health literacy among African American women. The public health relevance of such knowledge lies in its potential to decrease health disparities in a significant minority population.