Refining Entertainment Education for Cancer Literacy in African American Women

描述（由申请人提供）：在美国，缺乏健康素养是一种广泛而严重的健康威胁(1)。娱乐教育（EE）将健康信息嵌入到娱乐叙事中(2)，并有望提高广大受众的健康素养。本研究将调查在音频肥皂剧中操纵三个叙事元素的影响，其中包括EE推荐的乳腺癌和结直肠癌筛查信息。研究的参与者将是50岁以上的非裔美国妇女，这些人报告说从肥皂剧中获得了健康信息（54），并建议对他们进行这些疾病的筛查(6)。该研究将以运输/意象模型(4)为指导，该模型认为，只有当受众成员感到被转移或“被运送”到叙事世界中时，接触叙事才能改变健康行为及其决定因素。我们假设肥皂剧听众在结果测量上的得分会高于收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交通水平会更高：(a)癌症筛查信息嵌入了一个涉及主要人物的中心情节，而不是涉及次要人物的次要情节；(b)叙事是一个一贯严肃基调的戏剧，而不是喜剧；(c)情节奖励了被筛查的角色，结果立即是阴性的，而不是因为筛查结果是阳性的，而最终成功的治疗结果。当交通评分增加时，我们预测癌症知识、其他社会心理筛查决定因素、寻求信息和筛查的意图以及实际的信息寻求和筛查行为（如预约）都会增加。形成性研究将指导各种版本的音频肥皂剧的发展，其中将包括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种版本的肥皂剧。参与者将在播放录音带前后和一个月后立即完成问卷调查。公共卫生相关性：与白人相比，非洲裔美国人的健康素养水平较低，非洲裔美国妇女在乳腺癌和结直肠癌筛查率、晚期诊断和死亡率方面存在阴性差异（8,9）。这项研究的长期目标是制定更有效的方式向非裔美国妇女传递健康信息并促进她们的健康素养。这种知识与公共卫生的相关性在于它有可能减少一个重要的少数民族人口的健康差距。

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.