Comparing narrative and informational videos to increase mammography in low-income African American women

Abstract

OBJECTIVE Compare effects of narrative and informational videos on use of mammography, cancer-related beliefs, recall of core content and a range of reactions to the videos. METHOD African American women (n=489) ages 40 and older were recruited from low-income neighborhoods in St. Louis, MO and randomly assigned to watch a narrative video comprised of stories from African American breast cancer survivors (Living Proof) or a content-equivalent informational video using a more expository and didactic approach (Facts for Life). Effects were measured immediately post-exposure and at 3- and 6-month follow-up. RESULTS The narrative video was better liked, enhanced recall, reduced counterarguing, increased breast cancer discussions with family members and was perceived as more novel. Women who watched the narrative video also reported fewer barriers to mammography, more confidence that mammograms work, and were more likely to perceive cancer as an important problem affecting African Americans. Use of mammography at 6-month follow-up did not differ for the narrative vs. informational groups overall (49% vs. 40%, p=.20), but did among women with less than a high school education (65% vs. 32%, p<.01), and trended in the same direction for those who had no close friends or family with breast cancer (49% vs. 31%, p=.06) and those who were less trusting of traditional cancer information sources (48% vs. 30%, p=.06). CONCLUSIONS Narrative forms of communication may increase the effectiveness of interventions to reduce cancer health disparities. PRACTICE IMPLICATIONS Narratives appear to have particular value in certain population sub-groups; identifying these groups and matching them to specific communication approaches may increase effectiveness.

A Pilot Study of a Culturally Targeted Video Intervention to Increase Participation of African American Patients in Cancer Clinical Trials

“…The use of real patients conveying their personal, unscripted narratives provides a unique and impactful perspective to our intervention medium. Narratives have been shown to be of particular value in AA populations in a study of mammography use and cancer-related beliefs [44,45]. Our study is the first to specifically address the attitudinal barriers to clinical trial participation faced by AAs and directly evaluate their intention to enroll.…”

Examining the role of patients’ experiences as a resource for choice and decision-making in health care: a creative, interdisciplinary mixed-method study in digital health

“…176,177 Emerging work by others is testing the value that narrative accounts could have in modifying attitudes to breast screening among African American women, 178,179 in helping people with hypertension achieve control of their blood pressure 180 and in achieving lifestyle change for people with coronary heart disease and low-back pain. 181 …”

Testing innovative strategies to reduce the social gradient in the uptake of bowel cancer screening: a programme of four qualitatively enhanced randomised controlled trials

“…159 Assuming α = 0.05 and power (1-β) = 0.90, the number of participants needed to find a significant between-group difference in intention in the current study was 684 (342 per group). A low response rate was anticipated and, therefore, approximately 4000 people were invited to take part.…”

“…[156][157][158] The positive influence of narratives has been highlighted within a number of health-related behaviours, including breast cancer screening, skin cancer prevention and hepatitis B vaccinations. [159][160][161] Intentions to take part in such health-promoting activities have been found to be higher after exposure to narrative information compared with either statistical information or no information at all. In a US-based study by Dillard et al, 162 incorporating narratives into information about bowel cancer screening increased perceived personal risk of bowel cancer.…”