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Toija A, Kettunen T, Kasila K. The Construction of Peer Support Among Recently Diagnosed Breast Cancer Patients. Cancer Nurs 2024:00002820-990000000-00231. [PMID: 38527125 DOI: 10.1097/ncc.0000000000001319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
BACKGROUND Breast cancer (BC) and its treatments decrease patients' psychological well-being. Peer support is one form of social support, but little is known about what gives rise to peer support. OBJECTIVE The purpose of this study was to examine how peer support is constructed among recently diagnosed BC patients. METHODS Eighteen women were randomly picked from 130 women who had received phone calls from a trained peer supporter and were invited to group interviews. In the interviews, patients discussed their cancer, peer support experiences, and social support. The transcribed data were analyzed using Braun and Clarke's thematic analysis approach. RESULTS The construction of peer support among newly diagnosed BC patients was complex. It depended on the needs of the patient and the success of interactions. Once they had received a diagnosis, the lives of the patients changed suddenly, and patients dove into the I-we-others consideration and had a need to talk. Interaction with peer supporters gave them a chance to share their stories. At their best, interactions led to belonging, caring, and a sense of security. CONCLUSIONS The need to be heard and seen is strong in a patient's changing health situation. Peer support plays an important role in high-standard care and in strengthening patients' self-determination. IMPLICATIONS FOR PRACTICE Hospitals should create chances for supportive communication, and the supportive communication should be easily accessible and successful. The training of peer supporters should ensure that they have reflected on their own BC process and know how to consider the needs of newly diagnosed patients.
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Affiliation(s)
- Anu Toija
- Author Affiliations: Faculty of Sport and Health Sciences, University of Jyväskylä (Mrs Toija, and Drs Kettunen and Kasila), Finland; and Nursing Management, HUS Group (the Joint Authority for Helsinki and Uusimaa), Helsinki University Hospital and University of Helsinki (Mrs Toija), Finland
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Collins MKR, Lazard AJ, Dillman Carpentier F, Comello ML, Benedict C, Kent EE, Yu C. Understanding Young Adult Cancer Survivors' Engagement with Cancer Storylines in Entertainment Media Narratives. J Adolesc Young Adult Oncol 2024. [PMID: 38743637 DOI: 10.1089/jayao.2023.0175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
Purpose: Some young adult cancer survivors (YACS; ages 18-39) struggle to incorporate their cancer experiences into their identities. Using stories, or narratives, is a new approach that could help YACS to integrate cancer and their identity. These stories offer opportunities to experience perspectives outside of oneself, which can build validation and self-compassion. However, little is known about whether stories about cancer (i.e., the threat itself) are beneficial. Method: YACS completed an online survey about their engagement with cancer storylines in entertainment media narratives (e.g., books, movies, and television shows). They also described their reactions to encountering these storylines in entertainment media. Results: Participants (n = 108) were primarily White. Participants who sought cancer storylines reported a more positive impact of cancer on their sense of purpose and identity. Among YACS who had completed treatment, cancer storylines were sought after treatment more than during treatment. In addition, compared with their peers, participants who identified as Black reported greater cancer storyline seeking both during and after treatment. Nearly half of participants (n = 45, 47.4%) described reactions to cancer-related storylines as positive or mixed, primarily owing to feelings of inspiration or validation. Conclusion: Consuming cancer storylines can offer some benefits for YACS, especially among those finished with treatment and those who identify as Black. However, not all YACS responded positively, so future research should investigate which YACS could benefit most from cancer-related storylines. Nonetheless, entertainment media narratives represent a novel approach to supporting YACS' integration of cancer into their identity.
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Affiliation(s)
- Meredith K Reffner Collins
- Section of Pediatric Population Science, Outcomes, and Disparities Research, Division of Pediatric Hematology/Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Allison J Lazard
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at, Chapel Hill, North Carolina, USA
| | | | - Maria Leonora Comello
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Catherine Benedict
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, California, USA
- Stanford Cancer Institute, Stanford, California, USA
| | - Erin E Kent
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at, Chapel Hill, North Carolina, USA
| | - Clara Yu
- Section of Pediatric Population Science, Outcomes, and Disparities Research, Division of Pediatric Hematology/Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
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Worsdale A, Liu J. Narrative Messages and the Use of Emotional Appeals on Endometriosis Screening Intention: The Mediating Role of Positive Affect. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6209. [PMID: 37444056 PMCID: PMC10341228 DOI: 10.3390/ijerph20136209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/10/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023]
Abstract
Endometriosis affects around 10% of women globally, yet the awareness and screening rates for this condition are relatively low. Utilizing an online survey-based experiment with a sample of 18-30-year-old young women (N = 326), this study aimed to investigate the efficacy of narrative messages vs. non-narrative messages for promoting endometriosis screening intention, as well as to evaluate the effectiveness of hope appeal vs. fear appeal in narrative messages. The study also examined the potential mediating mechanisms through self-efficacy and positive affect responses that may help elucidate the effect of emotional appeals on behavioral intentions, while taking into account an individual's readiness to change. Findings indicated that narrative and non-narrative messages did not produce significantly different screening intentions. Compared to the use of fear appeal, the hope appeal in narrative messages predicted a higher level of positive affect responses, which was associated with increased endometriosis screening intentions. Individual difference in readiness to engage in endometriosis screening was not found to be a significant moderator. These results have implications for future research utilizing hope appeals in narrative health messaging. The observed significant mediational pathway through positive affect advances understanding of positive discrete emotions as facilitators to health-related cognition and behavior changes.
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Affiliation(s)
- Allison Worsdale
- Department of Communication Studies, University of Georgia, Athens, GA 30602, USA
| | - Jiaying Liu
- Department of Communication, University of California Santa Barbara, Santa Barbara, CA 93106, USA;
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Jackson LE, Saag KG, Chiriboga G, Lemon SC, Allison JJ, Mudano A, Rosas G, Foster PJ, Danila MI. A multi-step approach to develop a "storytelling" intervention to improve patient gout knowledge and improve outpatient follow-up. Contemp Clin Trials Commun 2023; 33:101149. [PMID: 37397431 PMCID: PMC10313880 DOI: 10.1016/j.conctc.2023.101149] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/06/2023] [Accepted: 05/13/2023] [Indexed: 07/04/2023] Open
Abstract
Background "Storytelling" interventions influence knowledge, attitudes and behavior to promote chronic disease management. We aimed to describe the development of a video "storytelling" intervention to increase gout knowledge and promote adherence to medications and follow-up care after an acute gout flare visit in the emergency department. Methods We developed a direct-to-patient storytelling intervention to mitigate modifiable barriers to gout care and promote outpatient follow-up and medication adherence. We invited adult patients with gout as storytellers. We utilized a modified Delphi process involving gout experts to identify key themes to guide development of an intervention. Using a conceptual model, we selected stories to ensure delivery of evidence-based concepts and to maintain authenticity. Results Our video-based storytelling intervention consisted of segments addressing modifiable barriers to gout care. Four diverse gout patients were recruited as storytellers and interviewed with questions that covered gout diagnosis and care. Eleven international gout experts from diverse geographic locations generated and ranked items they considered important messages to promote outpatient gout care follow-up and treatment adherence. Filmed videos were truncated into segments and coded thematically. Distinct segments that captured desired messages were combined to form a cohesive narrative story based on gout patient experiences that conveyed evidence-based strategies to manage gout. Conclusions Using the Health Belief Model, we developed a culturally appropriate narrative intervention containing "storytelling" that can be tested as an approach to improve gout outcomes. The methods we describe may be generalizable to other chronic conditions requiring outpatient follow-up and medication adherence to improve outcomes.
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Affiliation(s)
- Lesley E. Jackson
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kenneth G. Saag
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Germán Chiriboga
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, Worcester, MA, USA
| | - Stephenie C. Lemon
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, Worcester, MA, USA
| | - Jeroan J. Allison
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, Worcester, MA, USA
| | - Amy Mudano
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Giovanna Rosas
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Phillip J. Foster
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Maria I. Danila
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
- Geriatrics Research Education and Clinical Center, Birmingham VA Medical Center, Birmingham, AL, USA
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Hartzler AL, Bartlett LE, Hobler MR, Reid N, Pryor JB, Kapnadak SG, Berry DL, Lober WB, Goss CH, Ramos KJ. Take on transplant: human-centered design of a patient education tool to facilitate informed discussions about lung transplant among people with cystic fibrosis. J Am Med Inform Assoc 2022; 30:26-37. [PMID: 36173364 PMCID: PMC9748576 DOI: 10.1093/jamia/ocac176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/10/2022] [Accepted: 09/23/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Lung transplant (LTx) saves lives in cystic fibrosis (CF). However, many potential candidates express uncertainty about LTx and die before receiving this treatment. CF guidelines recommend LTx education and clinical discussions well before the need for LTx arises, but limited patient resources exist. MATERIALS AND METHODS We engaged people with CF and CF physicians in human-centered design of "Take On Transplant" (TOT), a web-based education tool to prepare patients for LTx discussions. Across 3 phases, needs assessment, design groups, and iterative user testing of TOT, we refined TOT from wireframe prototypes, to an interactive website, to a fully functional intervention ready for clinical trials. RESULTS Fifty-five people with CF and 105 physicians identified information needs to prepare for LTx discussions. Design groups (n = 14 participants) then established core requirements: didactic education ("Resource Library"), patient narratives ("CF Stories"), frequently asked questions ("FAQ"), and self-assessment to tailor content ("My CF Stage"). Iterative usability testing (n = 39) optimized the design of CF Stories and prototype layout. We then developed the TOT website and demonstrated feasibility and preliminary efficacy of use through 2-week field testing (n = 9). DISCUSSION Our human-centered design process provided guidance for educational tools to serve the evolving needs of potential LTx candidates. Our findings support the process of patient deliberation as a foundation for shared decision-making in CF, and inform educational tools that could potentially translate beyond LTx. CONCLUSION TOT fills a critical gap in preparing people with CF for shared decision-making about LTx and may serve as a model for educational tools for other preference-sensitive decisions.
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Affiliation(s)
- Andrea L Hartzler
- Department of Biomedical Informatics and Medical Education, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Lauren E Bartlett
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Mara R Hobler
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Nick Reid
- Department of Biomedical Informatics and Medical Education, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Joseph B Pryor
- Department of General Internal Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Siddhartha G Kapnadak
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Donna L Berry
- Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA
| | - William B Lober
- Department of Biomedical Informatics and Medical Education, School of Medicine, University of Washington, Seattle, Washington, USA
- Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Christopher H Goss
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Kathleen J Ramos
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
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Adams ET, Nabi RL, Noar SM, Evans R, Widman L. How Emotional Shifts Effect Youth Perceptions of Opioid Risk and Efficacy: Testing a Know the Truth Campaign Narrative. HEALTH COMMUNICATION 2022; 37:1820-1831. [PMID: 33977833 PMCID: PMC8887820 DOI: 10.1080/10410236.2021.1921349] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Integrating the extended parallel process model (EPPM) and the emotional flow hypothesis, we tested the persuasive effect of emotional shifts during exposure to a Know the Truth anti-opioid campaign narrative in a sample of middle-school students (n = 480). Testing two emotional flow sequences (threat to efficacy and efficacy to threat) of the Know the Truth narrative against a static (threat-only) emotional condition, we found that youth exposed to any emotional flow narrative reported higher levels of hope and lower levels of fear than those exposed to a threat-only narrative. We also found that a threat to efficacy narrative elicited higher levels of self-efficacy than an efficacy to threat emotional flow condition, suggesting that the emotional sequence influences self-efficacy, a well-established predictor of health behavior change. We conclude that the traditional threat to efficacy emotional flow may be superior to its inverse (efficacy to threat) when communicating with young people about opioid addiction. Implications for message design are discussed.
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Affiliation(s)
| | - Robin L. Nabi
- Department of Communication, University of California at Santa Barbara
| | - Seth M. Noar
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill
| | - Reina Evans
- Department of Psychology, North Carolina State University
| | - Laura Widman
- Department of Psychology, North Carolina State University
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Lillie HM, Pokharel M, John KK, Christy KR, Upshaw S, Giorgi EA, Jensen JD. Does it matter if a story character lives or dies?: a message experiment comparing survivor and death narratives. Psychol Health 2022; 37:419-439. [PMID: 33464969 PMCID: PMC8286982 DOI: 10.1080/08870446.2021.1873337] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 12/06/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE In narratives, characters often face threats where they either live (survivor narratives) or die (death narratives). Both outcomes have the potential to persuade, and are frequently utilised in mass communication campaigns, yet more research is needed examining the relative effectiveness and underlying mechanisms of each strategy. DESIGN U.S. adults (N = 1010) were randomly assigned to a 2 (survivor, death) × 2 (non-foreshadowed, foreshadowed) × 2 (within-study replication: narrative 1, narrative 2) between-participants experiment with melanoma stories as stimuli. MAIN OUTCOME MEASURES Intentions to engage in sun safe behaviour and skin self-examination behaviour were assessed in the pre- and posttest, and then transformed into change scores. RESULTS Death narratives increased sun safe behaviour intentions. Consistent with the entertainment overcoming resistance model, foreshadowed death narratives were found to increase sun safe behaviour intentions via increased transportation and decreased counterarguing. CONCLUSION Compared to survivor narratives, death narratives increase intentions to engage in sun safe behaviour. The findings offer support for character death as a key feature of narrative persuasion, and narrative transportation and counterarguing as important mediational pathways.
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Affiliation(s)
| | | | | | - Katheryn R. Christy
- School of Journalism & Mass Communication, University of Wisconsin – Madison
| | - Sean Upshaw
- Moody College of Communication, University of Texas at Austin
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Nolan TS, Bell AM, Chan YN, Leak Bryant A, Bissram JS, Hirschey R. Use of Video Education Interventions to Increase Racial and Ethnic Diversity in Cancer Clinical Trials: A Systematic Review. Worldviews Evid Based Nurs 2021; 18:302-309. [PMID: 34561957 PMCID: PMC8483572 DOI: 10.1111/wvn.12539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Less than 5% of eligible adult cancer survivors participate in cancer clinical trials. Survivors identifying as Black, Indigenous, and people of color (BIPOC) are less likely to participate in clinical trials compared to those identifying as non-Hispanic White. Common barriers to BIPOC participation are lack of knowledge, lack of access, and mistrust. These barriers are all factors in the disparities observed in BIPOC cancer-related morbidity and mortality. Clinical trials need adequate BIPOC representation to garner generalizable findings that can reduce or eliminate cancer disparities associated with the social construct of race. AIM This systematic review examined the use of video education interventions to impact BIPOC survivor participation in clinical trials. METHODS Web of Science, Embase, PubMed, Cochrane, PsycInfo, and CINAHL databases were queried for articles that described or tested video interventions aimed at increasing adult, BIPOC survivor clinical trial participation. Two authors independently screened articles for inclusion, appraised quality, and abstracted relevant data. All authors synthesized the data into themes through discussion and consensus. RESULTS The search yielded 2,512 articles. Seven selected articles described six distinct interventions. Although the six interventions reduced barriers to participation in clinical trials, their findings varied on Black and Hispanic survivors' readiness to enroll and participate in trials. Four themes emerged: (a) cultural sensitivity is needed in video development and delivery; (b) video content should be aimed to educate and change attitudes about clinical trials; (c) video interventions are feasible and acceptable; and (d) video interventions affect outcomes on intention or actual enrollment. LINKING EVIDENCE TO ACTION Video interventions are well-received by BIPOC survivors and may improve representation in clinical trials. Yet, video interventions are underutilized. More studies are needed to establish best practices for video interventions aimed at diversifying clinical trial participation as widening cancer disparities and rapidly changing cancer care continue to emerge.
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Affiliation(s)
- Timiya S Nolan
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
- Comprehensive Cancer Center - The James, The Ohio State University, Columbus, Ohio, USA
| | - Ana' M Bell
- College of Education and Human Ecology, The Ohio State University, Columbus, Ohio, USA
| | - Ya-Ning Chan
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ashley Leak Bryant
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Jennifer S Bissram
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rachel Hirschey
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
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Vafeiadis M, Shen F. Effects of narratives, frames, and involvement on health message effectiveness. Health Mark Q 2021; 39:213-229. [PMID: 34406111 DOI: 10.1080/07359683.2021.1965824] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
An online 2 (evidence type: narrative vs. informational) × 2 (message frame: gain vs. loss) × 2 (involvement: low vs. high) between-subjects factorial experiment was conducted to examine their effects in skin cancer awareness campaigns. Results showed that loss-framed narratives were convincing for high-involved individuals, whereas both gain-framed informational and loss-framed narratives evoked higher issue attitudes and behavioral intentions for low-involved ones. Mediation analyses showed that identification with the story protagonist mediated narrative effects on the outcome variables. Theoretical and practical implications for sun protection awareness campaigns are discussed.
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Affiliation(s)
- Michail Vafeiadis
- School of Communication & Journalism, Auburn University, Auburn, Alabama, USA
| | - Fuyuan Shen
- Department of Advertising and Public Relations, Donald P. Bellisario College of Communications, Pennsylvania State University, State College, Pennsylvania, USA
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Lillie HM, Jensen JD, Pokharel M, Upshaw SJ. Death Narratives, Negative Emotion, and Counterarguing: Testing Fear, Anger, and Sadness as Mechanisms of Effect. JOURNAL OF HEALTH COMMUNICATION 2021; 26:586-595. [PMID: 34569434 PMCID: PMC8631252 DOI: 10.1080/10810730.2021.1981495] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Narrative messaging research has demonstrated that story outcome (e.g., whether the main character lives or dies) can impact audience behavior, but more research explicating and testing mechanistic pathways is needed. The current study tests fear, anger, and sadness as mechanisms of persuasion, assessing effects on counterarguing, reading flow, and behavioral intention. The current study utilized a 2 (story outcome: death vs. survivor) × 4 (story character: Marla, Erin, Don, and Ray) between-participants experiment (N = 735) to test the effect of story outcome on behavioral intentions via discrete emotion. Death narratives generated greater fear, anger, and sadness. Fear was related to greater behavioral intention and reading flow and diminished counterarguing. Sadness had the opposite effect. Anger produced a mixed persuasive effect, increasing both counterarguing and reading flow. Results have implications for discrete emotions theorizing and underscore the importance of conceptualizing narrative stimuli along multiple affective dimensions rather than single dimensions.
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Affiliation(s)
- Helen M Lillie
- Department of Communication, University of Utah, Salt Lake City, USA
| | - Jakob D Jensen
- Department of Communication, University of Utah, Salt Lake City, USA
| | - Manusheela Pokharel
- Department of Communication Studies, Texas State University, San Marcos, USA
| | - Sean J Upshaw
- Stan Richards School of Advertising and Public Relations, University of Texas-Austin, Austin, USA
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Zhou S, Shapiro MA. Effects of Egocentric Projection and Identification on Narrative Persuasion in Foodborne Illness Messages. JOURNAL OF HEALTH COMMUNICATION 2020; 25:931-942. [PMID: 33656415 DOI: 10.1080/10810730.2020.1868627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study conceptually and empirically distinguishes two mental processes in narrative processing of food safety health messages-identification with and egocentric projection onto story characters. Two studies examined the effects of narrative autobiographical accounts of contracting foodborne illness (salmonella) because of careless food preparation. Both studies consistently found that identification increased, but egocentric projection decreased audience members' behavioral intention to perform safe food handling practices, indicating that egocentric projection and identification represent unique mental processes and yield distinct persuasive outcomes. In addition, confirmatory factor analyses provided evidence that egocentric projection and identification are distinct constructs. Implications for the role of identification and egocentric projection for understanding narrative processing and for health persuasion are discussed.
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Affiliation(s)
- Shuo Zhou
- Department of Community & Behavioral Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
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Pérez M, Kreuter MW, Yan Y, Thompson T, Sefko J, Golla B, Margenthaler JA, Colditz G, Jeffe DB. Feasibility and Acceptability of an Interactive Cancer-Communication Video Program Using African American Breast Cancer Survivor Stories. JOURNAL OF HEALTH COMMUNICATION 2020; 25:566-575. [PMID: 33048635 PMCID: PMC8043508 DOI: 10.1080/10810730.2020.1821132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
To examine the feasibility and acceptability of an interactive video program of African American breast cancer survivor stories, we explored story reactions among African American women with newly diagnosed breast cancer and associations between patient factors and intervention use. During a randomized controlled trial, patients in the intervention arm completed a baseline/pre-intervention interview, received the video intervention, and completed a post-intervention 1-month follow-up interview. Additional video exposures and post-exposure interviews occurred at 6- and 12-month follow-ups. Multivariable linear mixed-effects models examined interview and clinical data in association with changes in minutes and actions using the program. After Exposure1, 104 of 108 patients allocated to the intervention reported moderate-to-high levels of positive emotional reactions to stories and identification with storytellers. Exposure1 mean usage was high (139 minutes) but declined over time (p <.0001). Patients receiving surgery plus radiation logged about 50 more minutes and actions over 12-month follow-up than patients receiving surgery only (p <.05); patients reporting greater trust in storytellers logged 18.6 fewer actions over time (p =.04). Patients' topical interests evolved, with patients watching more follow-up care and survivorship videos at Exposure3. The intervention was feasible and evaluated favorably. New videos might satisfy patients' changing interests.
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Affiliation(s)
- Maria Pérez
- School of Medicine, Department of Medicine, Washington
University in St. Louis, Saint Louis, Missouri, USA
| | - Matthew W. Kreuter
- The Brown School, Washington University in St. Louis, Saint
Louis, Missouri, USA
- Alvin J.Siteman Cancer Center at Barnes-Jewish Hospital and
Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Yan Yan
- Alvin J.Siteman Cancer Center at Barnes-Jewish Hospital and
Washington University School of Medicine, Saint Louis, Missouri, USA
- School of Medicine, Department of Surgery, Washington
University in St. Louis, St. Louis, Missouri, USA
| | - Tess Thompson
- The Brown School, Washington University in St. Louis, Saint
Louis, Missouri, USA
| | - Julianne Sefko
- School of Medicine, Department of Surgery, Washington
University in St. Louis, St. Louis, Missouri, USA
| | - Balaji Golla
- The Brown School, Washington University in St. Louis, Saint
Louis, Missouri, USA
| | - Julie A. Margenthaler
- Alvin J.Siteman Cancer Center at Barnes-Jewish Hospital and
Washington University School of Medicine, Saint Louis, Missouri, USA
- School of Medicine, Department of Surgery, Washington
University in St. Louis, St. Louis, Missouri, USA
| | - Graham Colditz
- Alvin J.Siteman Cancer Center at Barnes-Jewish Hospital and
Washington University School of Medicine, Saint Louis, Missouri, USA
- School of Medicine, Department of Surgery, Washington
University in St. Louis, St. Louis, Missouri, USA
| | - Donna B. Jeffe
- School of Medicine, Department of Medicine, Washington
University in St. Louis, Saint Louis, Missouri, USA
- Alvin J.Siteman Cancer Center at Barnes-Jewish Hospital and
Washington University School of Medicine, Saint Louis, Missouri, USA
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Shaffer VA, Focella ES, Hathaway A, Scherer LD, Zikmund-Fisher BJ. On the Usefulness of Narratives: An Interdisciplinary Review and Theoretical Model. Ann Behav Med 2019; 52:429-442. [PMID: 29684135 DOI: 10.1093/abm/kax008] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background How can we use stories from other people to promote better health experiences, improve judgments about health, and increase the quality of medical decisions without introducing bias, systematically persuading the listeners to change their attitudes, or altering behaviors in nonoptimal ways? More practically, should narratives be used in health education, promotion, or behavior change interventions? Method In this article, we address these questions by conducting a narrative review of a diverse body of literature on narratives from several disciplines to gain a better understanding about what narratives do, including their role in communication, engagement, recall, persuasion, and health behavior change. We also review broad theories about information processing and persuasion from psychology and more specific models about narrative messaging found in the health communication and marketing literatures to provide insight into the processes by which narratives have their effect on health behavior. Results To address major gaps in our theoretical understanding about how narratives work and what effects they will have on health behavior, we propose the Narrative Immersion Model, whose goal is to identify the parameters that predict the specific impact of a particular narrative (e.g. persuade, inform, comfort, etc.) based on the type of narrative message (e.g. process, experience, or outcome narrative). Further, the Narrative Immersion Model describes the magnitude of the effect as increasing through successive layers of engagement with the narrative: interest, identification, and immersion. Finally, the Narrative Immersion Model identifies characteristics of the narrative intervention that encourage greater immersion within a given narrative. Conclusions We believe there are important communication gaps in areas areas of behavioral medicine that could be addressed with narratives; however, more work is needed in order to employ narrative messaging systematically. The Narrative Immersion Model advances our theoretical understanding about narrative processing and its subsequent effects on knowledge, attitudes, and behavior.
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Affiliation(s)
- Victoria A Shaffer
- Department of Psychological Sciences, University of Missouri, Columbia, MO
| | | | - Andrew Hathaway
- Department of Psychological Sciences, University of Missouri, Columbia, MO
| | - Laura D Scherer
- Department of Psychological Sciences, University of Missouri, Columbia, MO
| | - Brian J Zikmund-Fisher
- Department of Health Education and Health Behavior, Department of Internal Medicine, Center for Bioethics and Social Sciences in Medicine (CBSSM), University of Michigan, Ann Arbor, MI
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15
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McQueen A, Caburnay C, Kreuter M, Sefko J. Improving Adherence to Colorectal Cancer Screening: A Randomized Intervention to Compare Screener vs. Survivor Narratives. JOURNAL OF HEALTH COMMUNICATION 2019; 24:141-155. [PMID: 30924402 PMCID: PMC6459702 DOI: 10.1080/10810730.2019.1587109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Interventions are needed to increase colorectal cancer screening (CRCS) uptake. Narratives may have advantages over didactic information. We tested different narratives for increasing CRCS intentions and behaviors, and examined their mechanisms of influence. We randomized 477 unscreened adults 50-75 years old to one of three groups: CRCS information only (1) or CRCS information plus a photo and text narrative of a CRC survivor (2) or CRC screener who did not have cancer (3). Photos were tailored on participants' sex, age group, and race/ethnicity. Participants completed online surveys before and after intervention exposure, and 1-, 6-, and 12-months follow-up. Thirty percent of participants completed CRCS. Narrative conditions (vs. information only) were negatively associated with intention, but also positively influenced intentions through greater emotional engagement. Survivor (vs. screener) narratives were positively associated with CRCS, and had mixed effects on intention - positively through emotional engagement and negatively through self-referencing engagement to self-efficacy. Survivor narratives elicited more negative affect, which had positive and negative influences on intention. Continued research using path models to understand the mechanisms of narrative effects will inform theory development and message design. Additional measurement evaluation is needed to adequately capture and then compare the effects of different components of narrative engagement.
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Affiliation(s)
- Amy McQueen
- Washington University in St. Louis, School of Medicine, 4523 Clayton Ave., Campus Box 8005, St. Louis MO 63110
| | - Charlene Caburnay
- Washington University in St. Louis, School of Social Work, 1 Brookings Dr., Campus Box 1196, St. Louis MO 63130
| | - Matthew Kreuter
- Washington University in St. Louis, School of Social Work, 1 Brookings Dr., Campus Box 1196, St. Louis MO 63130
| | - Julianne Sefko
- Washington University in St. Louis, School of Medicine, 4523 Clayton Ave., Campus Box 8005, St. Louis MO 63110
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16
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Hirschey R, Kimmick G, Hockenberry M, Shaw R, Pan W, Page C, Lipkus I. A randomized phase II trial of MOVING ON: An intervention to increase exercise outcome expectations among breast cancer survivors. Psychooncology 2018; 27:2450-2457. [PMID: 30071146 DOI: 10.1002/pon.4849] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/19/2018] [Accepted: 07/20/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The objective of the study is to test theoretical intervention fidelity and feasibility of MOVING ON, a self-directed, home-based, randomized controlled trial to increase exercise outcome expectations (OEs) (what one expects to obtain or avoid as a result of a behavior or lack thereof), among breast cancer survivors. METHOD Stage Ia to IIb survivors (n = 60) were given the MOVING ON intervention or control booklet. Data were collected through online surveys and an accelerometer at baseline, 4, 8, and 12 weeks postintervention. Fidelity was measured by questions assessing participant perceptions of MOVING ON (score ≥2) and direction of intervention effects. Feasibility was measured by recruitment rate (target of 60 participants in 6 months), retention (total attrition <17%), and acquisition of accelerometer data (% ≥subjective exercise data obtained). Analyses consisted of descriptive statistics, mixed models, and content analysis. RESULTS Fidelity met a priori criteria (mean = 3.31, SD = 0.87). Outcome expectations increased 0.01 points, and weekly steps increased by 970 every 4 weeks in the intervention arm compared to the control arm. All effect sizes were small, ranging from 0.01 to 0.09. Target enrollment, achieved in 17 weeks, met a priori feasibility criteria. Retention (66%) and accelerometer data acquisition (60%) (compared to 73% of subjective exercise data) did not. CONCLUSION MOVING ON influenced OEs as intended and was well received by participants. A fully powered study, of this low-cost, easy-to-implement intervention, is warranted. Intervention and measurement strategies used in MOVING ON can be incorporated in any study targeting OEs as a mediator of exercise or collecting exercise data with an accelerometer.
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Affiliation(s)
| | - Gretchen Kimmick
- Duke University Medical Center, Duke Cancer Institute, Durham, NC, USA
| | | | - Ryan Shaw
- Duke University School of Nursing, Durham, NC, USA
| | - Wei Pan
- Duke University School of Nursing, Durham, NC, USA
| | | | - Isaac Lipkus
- Duke University School of Nursing, Durham, NC, USA
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17
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Banerjee SC, D'Agostino TA, Gordon ML, Hay JL. "It's Not JUST Skin Cancer": Understanding Their Cancer Experience From Melanoma Survivor Narratives Shared Online. HEALTH COMMUNICATION 2018; 33:188-201. [PMID: 27982699 PMCID: PMC5474216 DOI: 10.1080/10410236.2016.1250707] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Cancer survivors narrate their experiences in unique ways, articulating different aspects of the cancer journey. The purpose of this study was to analyze the content of cancer narratives that melanoma survivors share online in order to present the ways that survivors narrate their cancer experience, to identify survivors' motivations for sharing, and to better understand the ways in which survivors are impacted by and cope with the diagnosis and treatment of cancer. The sample consisted of 95 unique melanoma survivor narratives, accessed from the Melanoma Research Foundation in November 2015, that were inductively and deductively coded for key themes and subthemes. Emergent themes described different aspects of the melanoma experience during prediagnosis (identification of self-phenotype, searching for causes, suspicious findings, delay in diagnosis), diagnosis (communication of diagnosis, emotional responses), transition from diagnosis to beginning treatment (second opinion), treatment (positive reframing of attitude, proactive cancer management, side effects), and posttreatment phases (social support, vigilance behaviors posttreatment). Two themes that cut across all phases of the cancer journey included recognizing and dealing with uncertainty and survivors' motive for sharing narrative. These findings have implications for understanding how melanoma survivors may benefit personally from sharing their cancer experience online and for the potential for survivor narratives to motivate behavior change and facilitate coping among readers.
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Affiliation(s)
- Smita C Banerjee
- a Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Center
| | - Thomas A D'Agostino
- a Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Center
| | - Mallorie L Gordon
- a Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Center
| | - Jennifer L Hay
- a Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Center
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18
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Hirschey R, Kimmick G, Hockenberry M, Shaw R, Pan W, Lipkus I. Protocol for Moving On: a randomized controlled trial to increase outcome expectations and exercise among breast cancer survivors. Nurs Open 2018; 5:101-108. [PMID: 29344401 PMCID: PMC5762707 DOI: 10.1002/nop2.119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 10/21/2017] [Indexed: 01/08/2023] Open
Abstract
Aim The aim of this study was to test the feasibility and fidelity of an intervention, Moving On, aimed to increase outcome expectations OEs (i.e. what one expects to obtain or avoid as a result of a behaviour) and exercise among breast cancer survivors. Design Randomized controlled trial. Methods Intervention arm participants will be given a theory-guided booklet that was co-created by the research team and three physically active breast cancer survivors who exercise to manage late and long-term treatment effects. Attention control arm participants will be given a similar booklet focused on diet. Participants will have 1 week to complete reading, writing and reflecting activities in the booklets. Study outcomes will be measured through online surveys; exercise will also be measured objectively with a Fitbit®. Four weeks postintervention, participants' thoughts about the usefulness, strengths and weakness of the intervention booklet will be assessed. OEs and exercise will be measured at baseline, 4-, 8- and 12-week postintervention.
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Affiliation(s)
| | | | | | - Ryan Shaw
- Duke University School of NursingDurhamNCUSA
| | - Wei Pan
- Duke University School of NursingDurhamNCUSA
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19
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Reid K, Hartling L, Ali S, Le A, Norris A, Scott SD. Development and Usability Evaluation of an Art and Narrative-Based Knowledge Translation Tool for Parents With a Child With Pediatric Chronic Pain: Multi-Method Study. J Med Internet Res 2017; 19:e412. [PMID: 29242180 PMCID: PMC5746621 DOI: 10.2196/jmir.8877] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 10/12/2017] [Accepted: 10/29/2017] [Indexed: 11/26/2022] Open
Abstract
Background Chronic pain in childhood is increasingly being recognized as a significant clinical problem for children and their families. Previous research has identified that families want information about the causes of their child’s chronic pain, treatment options, and effective strategies to help their child cope with the pain. Unfortunately, parents have reported that finding this information can be challenging. Objective The aim of this study was to actively work together with children attending a pediatric chronic pain clinic and their parents to develop, refine, and evaluate the usability of an art and narrative-based electronic book (e-book) for pediatric chronic pain. Methods A multiphase, multi-method research design employing patient engagement techniques was used to develop, refine, and evaluate the usability of an art and narrative based e-book for pediatric chronic pain management to facilitate knowledge translation for parents with a child with chronic pain. The multiple phases included the following: (1) qualitative interviews to compile parents’ narratives using qualitative interviews; (2) qualitative data analysis; (3) development of an e-book prototype; (4) expert clinician feedback; (5) parent usability evaluation, knowledge change, and confidence in knowledge responses using an electronic survey; (6) e-book refinement; and (7) dissemination of the e-book. Results A 48-page e-book was developed to characterize the experiences of a family living with a child with chronic pain. The e-book was a composite narrative of the parent interviews and encompassed descriptions of the effects the condition has on each member of the family. This was merged with the best available research evidence on the day-to-day management of pediatric chronic pain. The e-book was vetted for clinical accuracy by expert pediatric pain clinicians. All parents that participated in the usability evaluation (N=14) agreed or strongly agreed the content of the e-book was easy to understand and stated that they would recommend the e-book to other families who have children with chronic pain. Our research identified up to a 21.4% increase in knowledge after using the e-book, and paired t tests demonstrated a statistically significant difference in confidence in answering two of the five knowledge questions (chronic pain is a disease involving changes in the nervous system; the use of ibuprofen is usually effective at controlling chronic pain); t13=0.165, P=.001 and t13=0.336, P=.002, respectively, after being exposed to the e-book. Conclusions Our results demonstrate that parents positively rated an e-book developed for parents with a child with chronic pain. Our results also identify that overall, parents’ knowledge increased after using the e-book, and confidence in their knowledge about chronic pain and its management increased in two aspects after e-book exposure. These results suggest that art and narrative-based knowledge translation interventions may be useful in transferring complex health information to parents.
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Affiliation(s)
- Kathy Reid
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.,Stollery Children's Hospital, Alberta Health Services, Edmonton, AB, Canada
| | - Lisa Hartling
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Samina Ali
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.,Women & Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada
| | - Anne Le
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Allison Norris
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Shannon D Scott
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.,Women & Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada
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20
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Boeijinga A, Hoeken H, Sanders J. Storybridging: Four steps for constructing effective health narratives. HEALTH EDUCATION JOURNAL 2017; 76:923-935. [PMID: 29276232 PMCID: PMC5714161 DOI: 10.1177/0017896917725360] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To develop a practical step-by-step approach to constructing narrative health interventions in response to the mixed results and wide diversity of narratives used in health-related narrative persuasion research. METHOD Development work was guided by essential narrative characteristics as well as principles enshrined in the Health Action Process Approach. RESULTS The 'storybridging' method for constructing health narratives is described as consisting of four concrete steps: (a) identifying the stage of change, (b) identifying the key elements, (c) building the story, and (d) pre-testing the story. These steps are illustrated by means of a case study in which an effective narrative health intervention was developed for Dutch truck drivers: a high-risk, underprivileged occupational group. CONCLUSION Although time and labour intensive, the Storybridging approach suggests integrating the target audience as an important stakeholder throughout the development process. Implications and recommendations are provided for health promotion targeting truck drivers specifically and for constructing narrative health interventions in general.
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Affiliation(s)
- Anniek Boeijinga
- Centre for Language Studies, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Hans Hoeken
- Utrecht Institute of Linguistics OTS, Utrecht University, Utrecht, The Netherlands
| | - José Sanders
- Centre for Language Studies, Radboud University Nijmegen, Nijmegen, The Netherlands
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21
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Davis RE, Dal Cin S, Cole SM, Reyes LI, McKenney-Shubert SJ, Fleischer NL, Densen LC, Peterson KE. A Tale of Two Stories: An Exploration of Identification, Message Recall, and Narrative Preferences Among Low-Income, Mexican American Women. HEALTH COMMUNICATION 2017; 32:1409-1421. [PMID: 27767353 PMCID: PMC6208143 DOI: 10.1080/10410236.2016.1228029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Additional research is needed to guide the design of narratives for use in practice-oriented, naturalistic settings to maximize health behavior change, particularly among populations affected by health disparities. This mixed-methods study explored the influence of cultural tailoring and emotional arousal on identification and message recall in narratives promoting childhood obesity prevention among 40 Mexican American mothers. Participants were also asked about narrative exposure, narrative preferences, and beliefs about the purpose of a story. Participants were randomly assigned to listen to two stories: (a) a story tailored on noncultural or cultural variables, and (b) a story designed to enhance or minimize emotional arousal. Participants reported high engagement and identification with all stories. Participants generally envisioned protagonists as Latina, despite limited cues, and identified with protagonists in four ways: sharing personal characteristics; having similar thoughts and feelings; engaging in similar actions; and experiencing similar situations. Mothers were most interested in narratives that helped them to improve their lives. Findings from this study yield several hypotheses for consideration in future study, including ways in which story setting and message enactment may moderate message recall.
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Affiliation(s)
- Rachel E Davis
- a Department of Health Promotion, Education, and Behavior , University of South Carolina
| | - Sonya Dal Cin
- b Department of Communication Studies , University of Michigan
| | - Suzanne M Cole
- c Department of Nutritional Sciences, School of Public Health , University of Michigan
| | - Ligia I Reyes
- d Department of Health Promotion, Education, and Behavior , University of South Carolina
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22
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Dillard AJ, Ferrer RA, Welch JD. Associations between narrative transportation, risk perception and behaviour intentions following narrative messages about skin cancer. Psychol Health 2017; 33:573-593. [PMID: 28975805 DOI: 10.1080/08870446.2017.1380811] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Narrative messages may be an effective strategy to increase risk perceptions and motivate preventive behaviours related to cancer. The aim of this research was to examine associations between narrative transportation (i.e. psychological absorption into a narrative), risk perceptions, and intentions following narrative messages about skin cancer. DESIGN In two studies, women who reported indoor tanning read first-person narrative messages about skin cancer. We examined associations between narrative transportation and the women's responses to the narratives, including risk perceptions for skin cancer and behaviour intentions to reduce risk. Associations between transportation, knowledge and worry were also examined. RESULTS Greater transportation was associated with higher intentions to perform skin self-examination, talk to one's doctor about skin cancer, and look for more information. Greater transportation was also associated with higher gut feelings of risk and higher worry about skin cancer, but not deliberative risk perceptions or knowledge from the message. Additional analyses showed that after controlling for risk perception and worry, transportation had unique associations with some behaviour intentions. CONCLUSION Findings suggest that narrative transportation may be an important component to the persuasion of cancer narratives. Future research should explore ideas such as the role of the experiential system in narratives' influence.
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Affiliation(s)
- Amanda J Dillard
- a Department of Psychology , Grand Valley State University , Allendale , MI , USA
| | - Rebecca A Ferrer
- b Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences , National Cancer Institute , Bethesda , MD , USA
| | - Jessica D Welch
- a Department of Psychology , Grand Valley State University , Allendale , MI , USA
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23
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Moon TJ, Chih MY, Shah DV, Yoo W, Gustafson DH. Breast Cancer Survivors' Contribution to Psychosocial Adjustment of Newly Diagnosed Breast Cancer Patients in a Computer-Mediated Social Support Group. JOURNALISM & MASS COMMUNICATION QUARTERLY 2017; 94:486-514. [PMID: 34295137 PMCID: PMC8294206 DOI: 10.1177/1077699016687724] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
This study investigated the role of breast cancer survivors in a computer-mediated social support (CMSS) group for women with breast cancer. Applying a computer-aided content analytic method, the present study examined the differences in support provision between survivors and newly diagnosed patients. This study further investigated the impacts of survivor-provided social support on psychosocial adjustment of newly diagnosed patients. The results revealed that, compared with newly diagnosed patients, breast cancer survivors provided more emotional and informational support. Receiving emotional support from survivors contributed to an improvement in the quality of life and the depression of patients. The effects of survivor-provided informational support were not significant.
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Christy KR, Jensen JD, Sarapin SH, Yale RN, Weaver J, Pokharel M. Theorizing the Impact of Targeted Narratives: Model Admiration and Narrative Memorability. JOURNAL OF HEALTH COMMUNICATION 2017; 22:433-441. [PMID: 28414617 DOI: 10.1080/10810730.2017.1303555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Communication campaigns often include components that have been designed for a specific population, a strategy referred to as targeting. Targeted narratives are story-based components of a campaign that feature a character or situation relevant to the intended audience. Though commonplace, few studies have explicated the underlying mechanisms by which targeted narratives exert influence. In a message evaluation study, 316 women aged 40-75 (Mage = 51.19, SD = 8.11) were exposed to one of two targeted narratives and asked to complete measures of model admiration, narrative memorability, and intentions to receive a mammography. Targeting was based upon affiliation with the Mormon church. The results revealed that the relationship between the targeted narratives and screening intentions was especially strong for women from the target population who admired the depicted models and found the stories memorable.
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Affiliation(s)
- Katheryn R Christy
- a Department of Communication , University of Utah , Salt Lake City , Utah , USA
| | - Jakob D Jensen
- a Department of Communication , University of Utah , Salt Lake City , Utah , USA
- b Cancer Control and Population Sciences Core , Huntsman Cancer Institute , Salt Lake City , Utah , USA
| | - Susan H Sarapin
- c Hall School of Journalism and Communication , Troy University , Montgomery , Alabama , USA
| | - Robert N Yale
- d Satish & Yasmin Gupta College of Business , University of Dallas , Irving , Texas , USA
| | - Jeremy Weaver
- a Department of Communication , University of Utah , Salt Lake City , Utah , USA
| | - Manusheela Pokharel
- a Department of Communication , University of Utah , Salt Lake City , Utah , USA
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Robillard A, Padi A, Lewis K, Julious C, Troutman J. Advice for prevention from HIV-positive African-American women: 'My story is not just a story'. CULTURE, HEALTH & SEXUALITY 2017; 19:630-642. [PMID: 27796161 DOI: 10.1080/13691058.2016.1243732] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Large disparities in HIV incidence, prevalence and mortality exist for African-American women, especially in the southern region of the USA. Based on the culture-centric health promotion model, HIV-positive African American women can use their stories to support primary prevention. The purpose of this study was to document advice from HIV-positive African-American women (n = 25) to young African-American women, as described in their own cultural narratives collected through qualitative interviews. Content analysis of women's advice identified five common themes revolving broadly around: (1) advice for prevention, (2) support systems for prevention, (3) education, (4) empowerment/self-care and (5) potential barriers to prevention. Advice reflected recommendations based on personal experience and highlighted social determinants linked to HIV, such as stigma, access to education and healthcare, social support, and gender and power dynamics. Women also offered advice for coping with an HIV-positive diagnosis. Communication with parents, family and friends regarding education and social support emerged as an important interpersonal factor for participants, as were interactions with sexual/romantic partners. Stigma, at the community level, was consistently discussed as a hindrance to prevention. Narratives of HIV-positive women as community health agents of change can enhance the effectiveness of HIV prevention interventions for young US African-American women.
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Affiliation(s)
- Alyssa Robillard
- a Health Promotion, Education, and Behavior , University of South Carolina, Arnold School of Public Health , Columbia , USA
| | - Akhila Padi
- a Health Promotion, Education, and Behavior , University of South Carolina, Arnold School of Public Health , Columbia , USA
| | - Kaleea Lewis
- a Health Promotion, Education, and Behavior , University of South Carolina, Arnold School of Public Health , Columbia , USA
| | - Carmen Julious
- b Palmetto AIDS Life Support Services Inc , Columbia , USA
| | - Jamie Troutman
- a Health Promotion, Education, and Behavior , University of South Carolina, Arnold School of Public Health , Columbia , USA
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26
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Perrier MJ, Martin Ginis KA. Narrative interventions for health screening behaviours: A systematic review. J Health Psychol 2017; 22:375-393. [PMID: 26359288 DOI: 10.1177/1359105315603463] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Health information can be presented in different formats, such as a statistically-based or a story-based (e.g. narrative) format; however, there is no consensus on the ideal way to present screening information. This systematic review summarizes the literature pertaining to narrative interventions' efficacy at changing screening behaviour and its determinants. Five psychology and public health databases were searched; 19 studies, 18 focused on cancer and 1 on sexual health, met eligibility criteria. There is consistent evidence supporting the efficacy of narratives, but mixed evidence supporting an advantage for narratives over statistical interventions for screening behaviour and its determinants. Further investigation is warranted.
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Jensen JD, Yale RN, Krakow M, John KK, King AJ. Theorizing Foreshadowed Death Narratives: Examining the Impact of Character Death on Narrative Processing and Skin Self-Exam Intentions. JOURNAL OF HEALTH COMMUNICATION 2017; 22:84-93. [PMID: 28060585 PMCID: PMC5657478 DOI: 10.1080/10810730.2016.1252816] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Narratives are common in health campaigns and interventions, with many depicting individuals battling a particular illness or disease. Past research has focused primarily on the form and effects of survivor stories, but considerably less attention has been devoted to stories in which 1 or more of the central characters passes away. The goal of the current study was to compare the relative persuasive impact of survivor and death narratives in influencing skin prevention behaviors and to test narrative mediators that might explicate underlying mechanisms of effect. To that end, adults (N = 635, M age = 32.43 [SD = 11.23]) were randomly assigned to 1 of 6 narrative intervention conditions in an online message experiment. Participants read 1 of 2 stories about a person with melanoma (Rusty or Diane) that was manipulated as a narrative depicting the survival, death, or foreshadowed death of the main character. Foreshadowed death narratives increased intentions to perform a skin self-exam (SSE), a relationship that was mediated by narrative transportation and perceived SSE benefits. The results support the central postulate of narrative transportation theory and the utility of using foreshadowed death narratives in communication-based interventions designed to increase SSE frequency.
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Affiliation(s)
- Jakob D Jensen
- a Department of Communication , University of Utah , Salt Lake City , Utah , USA
| | - Robert N Yale
- b Satish and Yasmin Gupta College of Business , University of Dallas , Dallas , Texas , USA
| | | | - Kevin K John
- d School of Communication , Brigham Young University , Provo , Utah , USA
| | - Andy J King
- e Department of Public Relations , Texas Tech University , Lubbock , Texas , USA
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Rosal MC, Haughton CF, Estabrook BB, Wang ML, Chiriboga G, Nguyen OHT, Person SD, Lemon SC. Fresh Start, a postpartum weight loss intervention for diverse low-income women: design and methods for a randomized clinical trial. BMC Public Health 2016; 16:953. [PMID: 27612615 PMCID: PMC5016872 DOI: 10.1186/s12889-016-3520-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 06/20/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Overweight and obesity are prevalent among young women and are greater among minority and low-income women. The postpartum period is critical in women's weight trajectories as many women do not lose their pregnancy weight, and others lose some and then plateau or experience weight gain. Excess weight puts women at greater risk of chronic disease and thus weight loss in the postpartum period may be key to the long-term health of young women. This paper describes the design and methods of a randomized clinical trial of Fresh Start, an innovative narrative-based group intervention aimed at promoting postpartum weight loss among low-income, diverse women. METHODS/DESIGN Study participants were recruited from the five sites of the Women, Infants and Children (WIC) program in central Massachusetts. Participants were English-speaking, age ≥ 18 years, 6 weeks to 6 months postpartum, with a body mass index (BMI) ≥ 27 kg/m(2). The Fresh Start postpartum weight loss intervention, adapted from the Diabetes Prevention Program (DPP) in collaboration with WIC staff and clients, consisted of an 8-week group-based curriculum followed by nine monthly telephone calls. It included a narrative component (i.e., storytelling), group discussions, print materials and access to exercise facilities. The study is a two-arm randomized controlled trial. The control condition included print materials and access to exercise facilities. In-person assessments were conducted at baseline and at 6 and 12 months following the eight-week intervention phase. DISCUSSION The Fresh Start intervention translated key elements of an evidence-based weight loss protocol into a format that is hypothesized to be relevant, acceptable and effective for the target audience of low-SES postpartum women. This novel intervention was developed in collaboration with WIC to be sustainable within the context of its clinics, which reach approximately 9 million individuals per year across the U.S. via 10,000 clinics. TRIAL REGISTRATION clinicaltrials.gov NCT02176915 . Registered 25 June 2014.
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Affiliation(s)
- Milagros C. Rosal
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655-0002 USA
| | - Christina F. Haughton
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655-0002 USA
| | - Barbara B. Estabrook
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655-0002 USA
| | - Monica L. Wang
- Boston University School of Public Health, 801 Massachusetts Avenue, Boston, MA 02215 USA
- Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02215 USA
| | - Germán Chiriboga
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655 USA
| | - Oahn H. T. Nguyen
- Family Health Center of Worcester, Inc, 26 Queen Street, Worcester, MA 01610 USA
| | - Sharina D. Person
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655 USA
| | - Stephenie C. Lemon
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655-0002 USA
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Cueva M, Kuhnley R, Revels L, Schoenberg NE, Lanier A, Dignan M. Engaging Elements of Cancer-Related Digital Stories in Alaska. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:500-5. [PMID: 25865400 PMCID: PMC4605835 DOI: 10.1007/s13187-015-0826-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
The tradition of storytelling is an integral part of Alaska Native cultures that continues to be a way of passing on knowledge. Using a story-based approach to share cancer education is grounded in Alaska Native traditions and people's experiences and has the potential to positively impact cancer knowledge, understandings, and wellness choices. Community health workers (CHWs) in Alaska created a personal digital story as part of a 5-day, in-person cancer education course. To identify engaging elements of digital stories among Alaska Native people, one focus group was held in each of three different Alaska communities with a total of 29 adult participants. After viewing CHWs' digital stories created during CHW cancer education courses, focus group participants commented verbally and in writing about cultural relevance, engaging elements, information learned, and intent to change health behavior. Digital stories were described by Alaska focus group participants as being culturally respectful, informational, inspiring, and motivational. Viewers shared that they liked digital stories because they were short (only 2-3 min); nondirective and not preachy; emotional, told as a personal story and not just facts and figures; and relevant, using photos that showed Alaskan places and people.
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Affiliation(s)
- Melany Cueva
- Community Health Aide Program, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr., Anchorage, AK 99508, USA
| | - Regina Kuhnley
- Community Health Aide Program, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr., Anchorage, AK 99508, USA
| | - Laura Revels
- Clinical and Research Services, Alaska Native Tribal Health Consortium, 3900 Ambassador Drive, Anchorage, AK 99508, USA
| | - Nancy E. Schoenberg
- Marion Pearsall Professor of Behavioral Science, 125 Medical Behavioral Science Building, University of Kentucky, Lexington, KY 40536-0086, USA
| | - Anne Lanier
- Alaska Native Tribal Health Consortium, 3900 Ambassador Dr., Anchorage, AK 99508, USA
| | - Mark Dignan
- Department of Internal Medicine, University of Kentucky College of Medicine, 800 Rose Street Room CC444, Lexington, KY 40536, USA
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Visser LNC, Hillen MA, Verdam MGE, Bol N, de Haes HCJM, Smets EMA. Assessing engagement while viewing video vignettes; validation of the Video Engagement Scale (VES). PATIENT EDUCATION AND COUNSELING 2016; 99:227-235. [PMID: 26395312 DOI: 10.1016/j.pec.2015.08.029] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 08/13/2015] [Accepted: 08/22/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES In health communication research using video vignettes, it is important to assess viewers' engagement. Engagement scores can indicate ecological validity of the design, and help distinguish between different engagement types. Therefore, we aimed to develop and validate a scale assessing viewers' engagement with video vignettes. METHODS Based on an existing question set, the 15-item, five-dimensional Video Engagement Scale (VES) was developed. The VES was validated in two video-vignettes studies to investigate patient-physician communication. In addition to engagement, we assessed its presumed correlates, e.g., perceived realism of the video and identification with the patient. RESULTS Internal consistency and test-retest reliability were adequate in both studies (N=181 and N=228). Positive correlations between the VES and perceived realism of the video, credibility of and identification with the patient suggested good content validity. Confirmatory factor analysis suggested a four-dimensional model fit, largely resembling our hypothesized model. CONCLUSIONS The VES reliably and validly measures viewers' engagement in health communication research using video vignettes. It can be employed to assess ecological validity of this design. Further testing of the scale is needed to more solidly establish its dimensionality. PRACTICE IMPLICATIONS We recommend that researchers use the VES, to ensure ecological validity of future video-vignettes studies.
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Affiliation(s)
- Leonie N C Visser
- Department of Medical Psychology-Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Marij A Hillen
- Department of Medical Psychology-Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Mathilde G E Verdam
- Department of Medical Psychology-Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Nadine Bol
- Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, The Netherlands
| | - Hanneke C J M de Haes
- Department of Medical Psychology-Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Ellen M A Smets
- Department of Medical Psychology-Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Wong CA, Ostapovich G, Kramer-Golinkoff E, Griffis H, Asch DA, Merchant RM. How U.S. children's hospitals use social media: A mixed methods study. HEALTHCARE-THE JOURNAL OF DELIVERY SCIENCE AND INNOVATION 2015; 4:15-21. [PMID: 27001094 DOI: 10.1016/j.hjdsi.2015.12.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 12/11/2015] [Accepted: 12/15/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Social media provide new channels for hospitals to engage with communities, a goal of increasing importance as non-profit hospitals face stricter definitions of community benefit under the Affordable Care Act. We describe the variability in social media presence among US children's hospitals and the distribution of their Facebook content curation. METHODS Social media data from freestanding children's hospitals were extracted from September-November 2013. Social media adoption was reviewed for each hospital-generated Facebook, Twitter, YouTube, Google+ and Pinterest platform. Facebook page (number of Likes) and Twitter account (number of followers) engagement were examined by hospital characteristics. Facebook posts from each hospital over a 6-week period were thematically characterized. RESULTS We reviewed 5 social media platforms attributed to 45 children's hospitals and 2004 associated Facebook posts. All hospitals maintained Facebook and Twitter accounts and most used YouTube (82%), Google+ (53%) and Pinterest (69%). Larger hospitals were more often high performers for Facebook (67% versus 10%, p<0.01) and Twitter (75% versus 17%, p<0.05) engagement than small hospitals. The most common Facebook post-themes were hospital promotion 35% (706), education and information 35% (694), community partnership or benefit 24% (474), fundraising 21% (426), and narratives 12% (241). Of health education posts, 73% (509) provided pediatric health supervision and anticipatory guidance. CONCLUSIONS Social media adoption by US children's hospitals was widespread. IMPLICATIONS Beyond its traditional marketing role, social media can serve as a conduit for health education, engagement with communities, including community benefit.
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Affiliation(s)
- Charlene A Wong
- Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia, PA, USA; Penn Medicine Social Media and Health Innovation Lab, Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA.
| | - Gabrielle Ostapovich
- Penn Medicine Social Media and Health Innovation Lab, Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA
| | - Emily Kramer-Golinkoff
- Penn Medicine Social Media and Health Innovation Lab, Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA
| | - Heather Griffis
- Penn Medicine Social Media and Health Innovation Lab, Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA
| | - David A Asch
- Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia, PA, USA; Penn Medicine Social Media and Health Innovation Lab, Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA; Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA; Center for Health Equity Research and Promotion, The Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Raina M Merchant
- Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia, PA, USA; Penn Medicine Social Media and Health Innovation Lab, Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA; Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Goddu AP, Raffel KE, Peek ME. A story of change: The influence of narrative on African-Americans with diabetes. PATIENT EDUCATION AND COUNSELING 2015; 98:1017-24. [PMID: 25986500 PMCID: PMC4492448 DOI: 10.1016/j.pec.2015.03.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 03/24/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To understand if narratives can be effective tools for diabetes empowerment, from the perspective of African-American participants in a program that improved diabetes self-efficacy and self-management. METHODS In-depth interviews and focus groups were conducted with program graduates. Participants were asked to comment on the program's film, storytelling, and role-play, and whether those narratives had contributed to their diabetes behavior change. An iterative process of coding, analyzing, and summarizing transcripts was completed using the framework approach. RESULTS African-American adults (n=36) with diabetes reported that narratives positively influenced the diabetes behavior change they had experienced by improving their attitudes/beliefs while increasing their knowledge/skills. The social proliferation of narrative - discussing stories, rehearsing their messages with role-play, and building social support through storytelling - was reported as especially influential. CONCLUSION Utilizing narratives in group settings may facilitate health behavior change, particularly in minority communities with traditions of storytelling. Theoretical models explaining narrative's effect on behavior change should consider the social context of narratives. PRACTICE IMPLICATIONS Narratives may be promising tools to promote diabetes empowerment. Interventions using narratives may be more effective if they include group time to discuss and rehearse the stories presented, and if they foster an environment conducive to social support among participants.
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Affiliation(s)
- Anna P Goddu
- Department of Medicine, University of Chicago, Chicago, USA; Center for Health and the Social Sciences, University of Chicago, Chicago, USA; Chicago Center for Diabetes Translation Research, Chicago, USA
| | - Katie E Raffel
- Pritzker School of Medicine, University of Chicago, Chicago, USA
| | - Monica E Peek
- Department of Medicine, University of Chicago, Chicago, USA; Center for Health and the Social Sciences, University of Chicago, Chicago, USA; Chicago Center for Diabetes Translation Research, Chicago, USA; Center for the Study of Race, Politics and Culture, University of Chicago, Chicago, USA.
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Affiliation(s)
- Guy Itzchakov
- School of Business Administration, Hebrew University of Jerusalem
| | - Dotan R. Castro
- School of Business Administration, Hebrew University of Jerusalem
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Warriner AH, Outman RC, Allison JJ, Curtis JR, Markward NJ, Redden DT, Safford MM, Stanek EJ, Steinkellner AR, Saag KG. An Internet-based Controlled Trial Aimed to Improve Osteoporosis Prevention among Chronic Glucocorticoid Users. J Rheumatol 2015; 42:1478-83. [PMID: 26136484 DOI: 10.3899/jrheum.141238] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2015] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To address the low prevention and treatment rates for those at risk of glucocorticoid-induced osteoporosis (GIOP), we evaluated the influence of a direct-to-patient, Internet-based educational video intervention using "storytelling" on rates of antiosteoporosis medication use among chronic glucocorticoid users who were members of an online pharmacy refill service. METHODS We identified members who refilled ≥ 5 mg/day of prednisone (or equivalent) for 90 contiguous days and had no GIOP therapy for ≥ 12 months. Using patient stories, we developed an online video addressing risk factors and treatment options, and delivered it to members refilling a glucocorticoid prescription. The intervention consisted of two 45-day "Video ON" periods, during which the video automatically appeared at the time of refill, and two 45-day "Video OFF" periods, during which there was no video. Members could also "self-initiate" watching the video by going to the video link. We used an interrupted time series design to evaluate the effectiveness of this intervention on GIOP prescription therapies over 6 months. RESULTS Among 3017 members (64.8%) exposed to the intervention, 59% had measurable video viewing time, of which 3% "self-initiated" the video. The GIOP prescription rate in the "Video ON" group was 2.9% versus 2.7% for the "Video OFF" group. There was a nonsignificant trend toward greater GIOP prescription in members who self-initiated the video versus automated viewing (5.7% vs 2.9%, p = 0.1). CONCLUSION Among adults at high risk of GIOP, prescription rates were not significantly affected by an online educational video presented at the time of glucocorticoid refill. ClinicalTrials.gov Identifier: NCT01378689.
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Affiliation(s)
- Amy H Warriner
- From the Division of Endocrinology, Diabetes and Metabolism, and Division of Clinical Immunology and Rheumatology, and Department of Biostatistics, and Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts; Express Scripts, St. Louis, Missouri; Novartis Pharmaceuticals Corporation, East Hanover, New Jersey; Real Endpoints LLC, Westport, Connecticut, USA.A.H. Warriner, MD, Division of Endocrinology, Diabetes and Metabolism; R.C. Outman, MS, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; J.J. Allison, MD, MS, Department of Quantitative Health Sciences, University of Massachusetts Medical School; J.R. Curtis, MD, MS, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; N.J. Markward, PhD, Express Scripts; D.T. Redden, PhD, Department of Biostatistics; M.M. Safford, MD, Division of Preventive Medicine, University of Alabama at Birmingham; E.J. Stanek, PharmD, Novartis Pharmaceuticals Corporation; A.R. Steinkellner, PharmD, Express Scripts* and Real Endpoints LLC; K.G. Saag, MD, MSc, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham
| | - Ryan C Outman
- From the Division of Endocrinology, Diabetes and Metabolism, and Division of Clinical Immunology and Rheumatology, and Department of Biostatistics, and Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts; Express Scripts, St. Louis, Missouri; Novartis Pharmaceuticals Corporation, East Hanover, New Jersey; Real Endpoints LLC, Westport, Connecticut, USA.A.H. Warriner, MD, Division of Endocrinology, Diabetes and Metabolism; R.C. Outman, MS, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; J.J. Allison, MD, MS, Department of Quantitative Health Sciences, University of Massachusetts Medical School; J.R. Curtis, MD, MS, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; N.J. Markward, PhD, Express Scripts; D.T. Redden, PhD, Department of Biostatistics; M.M. Safford, MD, Division of Preventive Medicine, University of Alabama at Birmingham; E.J. Stanek, PharmD, Novartis Pharmaceuticals Corporation; A.R. Steinkellner, PharmD, Express Scripts* and Real Endpoints LLC; K.G. Saag, MD, MSc, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham
| | - Jeroan J Allison
- From the Division of Endocrinology, Diabetes and Metabolism, and Division of Clinical Immunology and Rheumatology, and Department of Biostatistics, and Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts; Express Scripts, St. Louis, Missouri; Novartis Pharmaceuticals Corporation, East Hanover, New Jersey; Real Endpoints LLC, Westport, Connecticut, USA.A.H. Warriner, MD, Division of Endocrinology, Diabetes and Metabolism; R.C. Outman, MS, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; J.J. Allison, MD, MS, Department of Quantitative Health Sciences, University of Massachusetts Medical School; J.R. Curtis, MD, MS, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; N.J. Markward, PhD, Express Scripts; D.T. Redden, PhD, Department of Biostatistics; M.M. Safford, MD, Division of Preventive Medicine, University of Alabama at Birmingham; E.J. Stanek, PharmD, Novartis Pharmaceuticals Corporation; A.R. Steinkellner, PharmD, Express Scripts* and Real Endpoints LLC; K.G. Saag, MD, MSc, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham
| | - Jeffrey R Curtis
- From the Division of Endocrinology, Diabetes and Metabolism, and Division of Clinical Immunology and Rheumatology, and Department of Biostatistics, and Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts; Express Scripts, St. Louis, Missouri; Novartis Pharmaceuticals Corporation, East Hanover, New Jersey; Real Endpoints LLC, Westport, Connecticut, USA.A.H. Warriner, MD, Division of Endocrinology, Diabetes and Metabolism; R.C. Outman, MS, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; J.J. Allison, MD, MS, Department of Quantitative Health Sciences, University of Massachusetts Medical School; J.R. Curtis, MD, MS, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; N.J. Markward, PhD, Express Scripts; D.T. Redden, PhD, Department of Biostatistics; M.M. Safford, MD, Division of Preventive Medicine, University of Alabama at Birmingham; E.J. Stanek, PharmD, Novartis Pharmaceuticals Corporation; A.R. Steinkellner, PharmD, Express Scripts* and Real Endpoints LLC; K.G. Saag, MD, MSc, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham
| | - Nathan J Markward
- From the Division of Endocrinology, Diabetes and Metabolism, and Division of Clinical Immunology and Rheumatology, and Department of Biostatistics, and Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts; Express Scripts, St. Louis, Missouri; Novartis Pharmaceuticals Corporation, East Hanover, New Jersey; Real Endpoints LLC, Westport, Connecticut, USA.A.H. Warriner, MD, Division of Endocrinology, Diabetes and Metabolism; R.C. Outman, MS, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; J.J. Allison, MD, MS, Department of Quantitative Health Sciences, University of Massachusetts Medical School; J.R. Curtis, MD, MS, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; N.J. Markward, PhD, Express Scripts; D.T. Redden, PhD, Department of Biostatistics; M.M. Safford, MD, Division of Preventive Medicine, University of Alabama at Birmingham; E.J. Stanek, PharmD, Novartis Pharmaceuticals Corporation; A.R. Steinkellner, PharmD, Express Scripts* and Real Endpoints LLC; K.G. Saag, MD, MSc, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham
| | - David T Redden
- From the Division of Endocrinology, Diabetes and Metabolism, and Division of Clinical Immunology and Rheumatology, and Department of Biostatistics, and Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts; Express Scripts, St. Louis, Missouri; Novartis Pharmaceuticals Corporation, East Hanover, New Jersey; Real Endpoints LLC, Westport, Connecticut, USA.A.H. Warriner, MD, Division of Endocrinology, Diabetes and Metabolism; R.C. Outman, MS, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; J.J. Allison, MD, MS, Department of Quantitative Health Sciences, University of Massachusetts Medical School; J.R. Curtis, MD, MS, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; N.J. Markward, PhD, Express Scripts; D.T. Redden, PhD, Department of Biostatistics; M.M. Safford, MD, Division of Preventive Medicine, University of Alabama at Birmingham; E.J. Stanek, PharmD, Novartis Pharmaceuticals Corporation; A.R. Steinkellner, PharmD, Express Scripts* and Real Endpoints LLC; K.G. Saag, MD, MSc, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham
| | - Monika M Safford
- From the Division of Endocrinology, Diabetes and Metabolism, and Division of Clinical Immunology and Rheumatology, and Department of Biostatistics, and Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts; Express Scripts, St. Louis, Missouri; Novartis Pharmaceuticals Corporation, East Hanover, New Jersey; Real Endpoints LLC, Westport, Connecticut, USA.A.H. Warriner, MD, Division of Endocrinology, Diabetes and Metabolism; R.C. Outman, MS, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; J.J. Allison, MD, MS, Department of Quantitative Health Sciences, University of Massachusetts Medical School; J.R. Curtis, MD, MS, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; N.J. Markward, PhD, Express Scripts; D.T. Redden, PhD, Department of Biostatistics; M.M. Safford, MD, Division of Preventive Medicine, University of Alabama at Birmingham; E.J. Stanek, PharmD, Novartis Pharmaceuticals Corporation; A.R. Steinkellner, PharmD, Express Scripts* and Real Endpoints LLC; K.G. Saag, MD, MSc, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham
| | - Eric J Stanek
- From the Division of Endocrinology, Diabetes and Metabolism, and Division of Clinical Immunology and Rheumatology, and Department of Biostatistics, and Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts; Express Scripts, St. Louis, Missouri; Novartis Pharmaceuticals Corporation, East Hanover, New Jersey; Real Endpoints LLC, Westport, Connecticut, USA.A.H. Warriner, MD, Division of Endocrinology, Diabetes and Metabolism; R.C. Outman, MS, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; J.J. Allison, MD, MS, Department of Quantitative Health Sciences, University of Massachusetts Medical School; J.R. Curtis, MD, MS, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; N.J. Markward, PhD, Express Scripts; D.T. Redden, PhD, Department of Biostatistics; M.M. Safford, MD, Division of Preventive Medicine, University of Alabama at Birmingham; E.J. Stanek, PharmD, Novartis Pharmaceuticals Corporation; A.R. Steinkellner, PharmD, Express Scripts* and Real Endpoints LLC; K.G. Saag, MD, MSc, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham
| | - Amy R Steinkellner
- From the Division of Endocrinology, Diabetes and Metabolism, and Division of Clinical Immunology and Rheumatology, and Department of Biostatistics, and Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts; Express Scripts, St. Louis, Missouri; Novartis Pharmaceuticals Corporation, East Hanover, New Jersey; Real Endpoints LLC, Westport, Connecticut, USA.A.H. Warriner, MD, Division of Endocrinology, Diabetes and Metabolism; R.C. Outman, MS, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; J.J. Allison, MD, MS, Department of Quantitative Health Sciences, University of Massachusetts Medical School; J.R. Curtis, MD, MS, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; N.J. Markward, PhD, Express Scripts; D.T. Redden, PhD, Department of Biostatistics; M.M. Safford, MD, Division of Preventive Medicine, University of Alabama at Birmingham; E.J. Stanek, PharmD, Novartis Pharmaceuticals Corporation; A.R. Steinkellner, PharmD, Express Scripts* and Real Endpoints LLC; K.G. Saag, MD, MSc, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham
| | - Kenneth G Saag
- From the Division of Endocrinology, Diabetes and Metabolism, and Division of Clinical Immunology and Rheumatology, and Department of Biostatistics, and Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts; Express Scripts, St. Louis, Missouri; Novartis Pharmaceuticals Corporation, East Hanover, New Jersey; Real Endpoints LLC, Westport, Connecticut, USA.A.H. Warriner, MD, Division of Endocrinology, Diabetes and Metabolism; R.C. Outman, MS, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; J.J. Allison, MD, MS, Department of Quantitative Health Sciences, University of Massachusetts Medical School; J.R. Curtis, MD, MS, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; N.J. Markward, PhD, Express Scripts; D.T. Redden, PhD, Department of Biostatistics; M.M. Safford, MD, Division of Preventive Medicine, University of Alabama at Birmingham; E.J. Stanek, PharmD, Novartis Pharmaceuticals Corporation; A.R. Steinkellner, PharmD, Express Scripts* and Real Endpoints LLC; K.G. Saag, MD, MSc, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham.
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Brand L, Beltran A, Buday R, O'Connor T, Hughes S, Baranowski J, Diep C, Lu AS, Baranowski T. Prose Fiction as a Narrative Companion for a Vegetable Parenting Videogame. Games Health J 2015; 4:305-11. [PMID: 26182218 DOI: 10.1089/g4h.2014.0143] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The purpose of this research is to explore the capacity of story to connect to a health-related videogame, as well as the qualities that may increase efficacy by making the story compelling. Parents of 3-5-year-old children often report difficulty getting their children to eat vegetables, which are protective against chronic illnesses. Videogames may be vehicles for training parenting practices for successful vegetable consumption outcomes but often rely on stories to provide context and details. Unfortunately, storytelling may interrupt immersion and player agency. Delivering stories outside of gameplay may provide an understanding of game situations while maintaining immersion. MATERIALS AND METHODS Two companion storylines (one a romantic adventure and the other a suspenseful fantasy) were generated for a vegetable parenting game, "Mommio," targeting mothers of preschool children. Mothers of 3-5-year-old children (n=18) read both storylines and completed semistructured interviews. RESULTS Mothers preferred the romantic adventure, which featured strong characters, relatable issues, and an engaging plot. Most mothers were interested in playing the "Mommio" videogame after reading the stories. CONCLUSIONS Results suggest that it is possible for prose literature to both motivate gameplay and be an immersive narrative companion to, but separate from, games for health. This literature should include engaging, realistic stories and relatable strong characters.
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Affiliation(s)
- Leah Brand
- 1 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
| | - Alicia Beltran
- 1 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
| | | | - Teresia O'Connor
- 1 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
| | - Sheryl Hughes
- 1 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
| | - Janice Baranowski
- 1 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
| | - Cassandra Diep
- 1 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
| | - Amy Shirong Lu
- 3 Department of Communication Studies, Northeastern University , Boston, Massachusetts
| | - Tom Baranowski
- 1 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
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Dillard AJ, Hisler G. Enhancing the effects of a narrative message through experiential information processing: An experimental study. Psychol Health 2015; 30:803-20. [DOI: 10.1080/08870446.2014.996565] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Larkey LK, McClain D, Roe DJ, Hector RD, Lopez AM, Sillanpaa B, Gonzalez J. Randomized controlled trial of storytelling compared to a personal risk tool intervention on colorectal cancer screening in low-income patients. Am J Health Promot 2015; 30:e59-70. [PMID: 25615708 DOI: 10.4278/ajhp.131111-quan-572] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE Screening rates for colorectal cancer (CRC) lag for low-income, minority populations, contributing to poorer survival rates. A model of storytelling as culture-centric health promotion was tested for promoting CRC screening. DESIGN A two-group parallel randomized controlled trial. SETTING Primary care, safety-net clinics. SUBJECTS Low-income patients due for CRC screening, ages 50 to 75 years, speaking English or Spanish. INTERVENTION Patients were exposed to either a video created from personal stories composited into a drama about "Papa" receiving CRC screening, or an instrument estimating level of personal cancer risk. Patients received a health care provider referral for CRC screening and were followed up for 3 months to document adherence. MEASURES Behavioral factors related to the narrative model (identification and engagement) and theory of planned behavior. ANALYSIS Main effects of the interventions on screening were tested, controlling for attrition factors, and demographic factor associations were assessed. Path analysis with model variables was used to test the direct effects and multiple mediator models. RESULTS Main effects on CRC screening (roughly half stool-based tests, half colonoscopy) did not indicate significant differences (37% and 42% screened for storytelling and risk-based messages, respectively; n = 539; 33.6% male; 62% Hispanic). Factors positively associated with CRC screening included being female, Hispanic, married or living with a partner, speaking Spanish, having a primary care provider, lower income, and no health insurance. Engagement, working through positive attitudes toward the behavior, predicted CRC screening. CONCLUSION A storytelling and a personalized risk-tool intervention achieved similar levels of screening among unscreened/underscreened, low-income patients. Factors usually associated with lower rates of screening (e.g., no insurance, being Hispanic) were related to more adherence. Both interventions' engagement factor facilitated positive attitudes about CRC screening associated with behavior change.
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Mollica MA, Nemeth LS, Newman SD, Mueller M, Sterba K. Peer navigation in African American breast cancer survivors. PATIENT-RELATED OUTCOME MEASURES 2014; 5:131-44. [PMID: 25404863 PMCID: PMC4230185 DOI: 10.2147/prom.s69744] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose The purpose of this study was to explore the feasibility and acceptability of a peer navigation survivorship program for African American (AA) breast cancer survivors (BCS) and its potential effects on selected short-term outcomes according to the Quality of Life Model Applied to Cancer Survivors. Methods An AA BCS who completed treatment over 1 year prior to the study was trained as a peer navigator (PN), and then paired with AA women completing primary breast cancer treatment (n=4) for 2 months. This mixed-methods, proof of concept study utilized a convergent parallel approach to explore feasibility and investigate whether changes in scores are favorable using interviews and self-administered questionnaires. Results Results indicate that the PN intervention was acceptable by both PN and BCS, and was feasible in outcomes of recruitment, cost, and time requirements. Improvements in symptom distress, perceived support from God, and preparedness for recovery outcomes were observed over time. Qualitative analysis revealed six themes emerging from BCS interviews: “learning to ask the right questions”, “start living life again”, “shifting my perspective”, “wanting to give back”, “home visits are powerful”, and “we both have a journey”: support from someone who has been there. Conclusion Results support current literature indicating that AA women who have survived breast cancer can be an important source of support, knowledge, and motivation for those completing breast cancer treatment. Areas for future research include standardization of training and larger randomized trials of PN intervention. Implications for cancer survivors The transition from breast cancer patient to survivor is a period when there can be a loss of safety net concurrent with persistent support needs. AA cancer survivors can benefit from culturally tailored support and services after treatment for breast cancer. With further testing, this PN intervention may aid in decreasing general symptom distress and increase readiness for recovery post-treatment.
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Affiliation(s)
- Michelle A Mollica
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Lynne S Nemeth
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Susan D Newman
- South Carolina Clinical and Translation Research Center for Community Health Partnerships, College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Martina Mueller
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Katherine Sterba
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
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Warriner AH, Outman RC, Feldstein AC, Roblin DW, Allison JJ, Curtis JR, Redden DT, Rix MM, Robinson BE, Rosales AG, Safford MM, Saag KG. Effect of self-referral on bone mineral density testing and osteoporosis treatment. Med Care 2014; 52:743-50. [PMID: 24984211 PMCID: PMC4101066 DOI: 10.1097/mlr.0000000000000170] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Despite national guidelines recommending bone mineral density screening with dual-energy x-ray absorptiometry (DXA) in women aged 65 years and older, many women do not receive initial screening. OBJECTIVE To determine the effectiveness of health system and patient-level interventions designed to increase appropriate DXA testing and osteoporosis treatment through (1) an invitation to self-refer for DXA (self-referral); (2) self-referral plus patient educational materials; and (3) usual care (UC, physician referral). RESEARCH DESIGN Parallel, group-randomized, controlled trials performed at Kaiser Permanente Northwest (KPNW) and Kaiser Permanente Georgia (KPG). SUBJECTS Women aged 65 years and older without a DXA in past 5 years. MEASURES DXA completion rates 90 days after intervention mailing and osteoporosis medication receipt 180 days after initial intervention mailing. RESULTS From >12,000 eligible women, those randomized to self-referral were significantly more likely to receive a DXA than UC (13.0%-24.1% self-referral vs. 4.9%-5.9% UC, P<0.05). DXA rates did not significantly increase with patient educational materials. Osteoporosis was detected in a greater proportion of self-referral women compared with UC (P<0.001). The number needed to receive an invitation to result in a DXA in KPNW and KPG regions was approximately 5 and 12, respectively. New osteoporosis prescription rates were low (0.8%-3.4%) but significantly greater among self-referral versus UC in KPNW. CONCLUSIONS DXA rates significantly improved with a mailed invitation to schedule a scan without physician referral. Providing women the opportunity to self-refer may be an effective, low-cost strategy to increase access for recommended osteoporosis screening.
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Affiliation(s)
- Amy H. Warriner
- Division of Endocrinology, Diabetes and Metabolism, University of Alabama at Birmingham
| | - Ryan C. Outman
- Division of Preventive Medicine, University of Alabama at Birmingham
| | | | | | - Jeroan J. Allison
- Department of Quantitative Health Sciences, University of Massachusetts Medical School
| | - Jeffrey R. Curtis
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham
| | - David T. Redden
- Department of Biostatistics, University of Alabama at Birmingham
| | - Mary M. Rix
- Kaiser Permanente Center for Health Research/Northwest, Portland, OR
| | | | | | - Monika M. Safford
- Division of Preventive Medicine, University of Alabama at Birmingham
| | - Kenneth G. Saag
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham
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The complexity of cancer survivorship: a case for personalized medicine. Report of the 2014 Grandangolo conference. ACTA ACUST UNITED AC 2014. [DOI: 10.1007/s12682-014-0182-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kreuter MW, McBride TD, Caburnay CA, Poor T, Thompson VLS, Alcaraz KI, Eddens KS, Rath S, Perkins H, Casey C. What can health communication science offer for ACA implementation? Five evidence-informed strategies for expanding Medicaid enrollment. Milbank Q 2014; 92:40-62. [PMID: 24597555 DOI: 10.1111/1468-0009.12040] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
CONTEXT Implementing the Affordable Care Act (ACA) in 2014 will require effective enrollment and outreach efforts to previously uninsured individuals now eligible for coverage. METHODS From 1996 to 2013, the Health Communication Research Laboratory conducted more than 40 original studies with more than 30,000 participants to learn how to improve the reach to and effectiveness of health information for low-income and racial/ethnic minority populations. We synthesized the findings from this body of research and used them to inform current challenges in implementing the ACA. FINDINGS We found empirical support for 5 recommendations regarding partnerships, outreach, messages and messengers, life priorities of low-income individuals and families, and the information environment. We translated these into 12 action steps. CONCLUSIONS Health communication science can inform the development and execution of strategies to increase the public's understanding of the ACA and to support the enrollment of eligible individuals into Medicaid or the Health Insurance Marketplace.
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Affiliation(s)
- Matthew W Kreuter
- Health Communication Research Laboratory, Washington University in St. Louis; Brown School of Social Work, Washington University in St. Louis
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Raffel KE, Goddu AP, Peek ME. "I Kept Coming for the Love": Enhancing the Retention of Urban African Americans in Diabetes Education. DIABETES EDUCATOR 2014; 40:351-360. [PMID: 24525568 DOI: 10.1177/0145721714522861] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE The purpose of the study was to investigate how retention strategies employed by the Diabetes Empowerment Program (DEP) contributed to retention. METHODS An experienced moderator conducted in-depth interviews (n = 7) and 4 focus groups (n = 29) with former DEP participants. Interviews were recorded, transcribed, and coded using iteratively modified coding guidelines. Results were analyzed using Atlas.ti 4.2 software. RESULTS Participants were African American and predominantly female, low income, and with more than 1 diabetes complication. Key retention themes included: (1) educator characteristics and interpersonal skills ("The warmth of the staff . . . kept me coming back for more."), (2) accessible information ("I didn't know anything about diabetes [before]. I was just given the medicine."), (3) social support ("I realized I wasn't the only one who has diabetes."), (4) the use of narrative ("It's enlightening to talk about [my diabetes]."), and (5) the African American helping tradition ("I went not just for myself but for my husband."). CONCLUSIONS While many interventions focus on costly logistics and incentives to retain at-risk participants, study findings suggest that utilizing culturally tailored curricula and emphasizing interpersonal skills and social support may be more effective strategies to retain low-income African Americans in diabetes education programs.
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Affiliation(s)
- Katie E Raffel
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois (Dr Raffel)
| | - Anna P Goddu
- Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, Illinois (Ms Goddu, Dr Peek),Center for Health and the Social Sciences, University of Chicago, Chicago, Illinois (Ms Goddu, Dr Peek),Chicago Center for Diabetes Translation Research, Chicago, Illinois (Ms Goddu, Dr Peek)
| | - Monica E Peek
- Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, Illinois (Ms Goddu, Dr Peek),Center for Health and the Social Sciences, University of Chicago, Chicago, Illinois (Ms Goddu, Dr Peek),Chicago Center for Diabetes Translation Research, Chicago, Illinois (Ms Goddu, Dr Peek),Center for the Study of Race, Politics and Culture, University of Chicago, Chicago, Illinois (Dr Peek)
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Dodson EA, Stamatakis KA, Chalifour S, Haire-Joshu D, McBride T, Brownson RC. State legislators' work on public health-related issues: what influences priorities? JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2013; 19:25-9. [PMID: 23169400 DOI: 10.1097/phh.0b013e318246475c] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
CONTEXT Policies are an effective way to influence population health and prevent disease. Unfortunately, public health research is often not well translated for policy audiences. Furthermore, researchers seeking to influence policy face an incomplete understanding of what influences legislators' decisions regarding which issues will receive their limited time and focus. OBJECTIVE The objective of this analysis was to examine various factors that may influence state legislators' decisions about which health issues they address. DESIGN Cross-sectional analysis of data collected from a randomized trial. SETTING State legislatures. PARTICIPANTS State-level legislators. MAIN OUTCOME MEASURE(S) Measures included a rating of the influence of various factors on health policy priorities. A 7-point scale was used to measure political ideology on social and fiscal issues. Standard demographic questions were included on age, gender, and level of education. RESULTS Seventy-five legislators completed surveys. Sixty-three percent were aged 55 years or older, and 76% male. When they were asked to rate factors according to importance in determining what health issues to work on, the top-rated factor was constituents' needs or opinions followed by evidence of scientific effectiveness. Ratings were also examined by subgroups. CONCLUSIONS These findings point to several important applications for public health practitioners and researchers. Because legislators value constituents' opinions, it is critical to inform and educate constituents about public health issues as well as policy options that may be effective in addressing problems. The results also highlight the importance of public health researchers and practitioners improving dissemination efforts to ensure that evidence-based scientific information is shared with policymakers in an effective and timely manner.
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Affiliation(s)
- Elizabeth A Dodson
- Prevention Research Center in St. Louis, and Brown School, Washington University in St. Louis, St Louis, Missouri 63110, USA.
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Vijaykumar S, Wray RJ, Jupka K, Clarke R, Shahid M. Prostate cancer survivors as community health educators: implications for informed decision making and cancer communication. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2013; 28:623-628. [PMID: 24096473 DOI: 10.1007/s13187-013-0559-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Recent evidence questioning the effectiveness of prostate-specific antigen testing leave community-based prostate cancer (CaP) outreach programs with a dilemma between promoting screening and highlighting screening risks. CaP survivors are uniquely positioned to address this problem by drawing upon real-life experiences to share nuanced information and perspectives. While CaP survivors have historically been incorporated into outreach programs, little is known about their impact on psychosocial outcomes and their effectiveness compared to professional health educators. This study addressed these gaps through a quasi-experimental design where African American men attended a CaP screening session conducted by a health educator (HE) or survivor educator (SV). The presentation included prostate cancer statistics, CaP information, and descriptions of CaP screening tests. SV were encouraged to bolster their presentations with personal stories whereas HE maintained fidelity to the curriculum content. All participants completed pre- and post-test questionnaires. Our sample comprised a total of 63 participants (HE group = 32; SV group = 31) with an age range of 40-70 years. Decision self-efficacy increased significantly in the SV group (p = 0.01) whereas perceived screening risks reduced significantly in the HE group (p < 0.001). No significant changes were found in knowledge, subjective norms, outcome expectancies, and screening benefits. Survivor educators were found to have significantly greater appeal (p = 0.03), identification with audience (p = 0.01), and liking (p = 0.03). Training CaP survivors as health educators might be a viable strategy for community-based cancer communication efforts confronted by the CaP screening controversy. We discuss conceptual and programmatic implications of our findings and present directions for future research.
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Affiliation(s)
- Santosh Vijaykumar
- Nanyang Technological University, Center of Social Media Innovations for Communities (COSMIC), 14 Nanyang Drive, HSS-06-15, Singapore, 637332, Singapore,
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Yoo JH, Kreuter MW, Lai C, Fu Q. Understanding narrative effects: the role of discrete negative emotions on message processing and attitudes among low-income African American women. HEALTH COMMUNICATION 2013; 29:494-504. [PMID: 24111724 PMCID: PMC4070308 DOI: 10.1080/10410236.2013.776001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
This study tests the processes through which breast cancer narrative messages are effective by taking a functional approach. We explore how discrete negative emotions (i.e., sadness, fear, and anger) induced by breast cancer survivor stories affect African American women's message processing, recall of message content, and attitudinal outcomes. Structural equation modeling was performed for narrative and informational versions of a breast cancer screening video shown to 489 low-income African American women ages 40 years and older. The model was well fitted. Sadness enhanced the persuasive process, while fear inhibited it. Sadness also helped participants recall more message-relevant content, while fear inhibited recall. Anger was not related to the persuasive process. Implications of these findings for narrative research and application are discussed.
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Affiliation(s)
- Jina H Yoo
- a Department of Communication , University of Missouri-St. Louis
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Nierkens V, Hartman MA, Nicolaou M, Vissenberg C, Beune EJAJ, Hosper K, van Valkengoed IG, Stronks K. Effectiveness of cultural adaptations of interventions aimed at smoking cessation, diet, and/or physical activity in ethnic minorities. a systematic review. PLoS One 2013; 8:e73373. [PMID: 24116000 PMCID: PMC3792111 DOI: 10.1371/journal.pone.0073373] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 07/25/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The importance of cultural adaptations in behavioral interventions targeting ethnic minorities in high-income societies is widely recognized. Little is known, however, about the effectiveness of specific cultural adaptations in such interventions. AIM To systematically review the effectiveness of specific cultural adaptations in interventions that target smoking cessation, diet, and/or physical activity and to explore features of such adaptations that may account for their effectiveness. METHODS Systematic review using MEDLINE, PsycINFO, Embase, and the Cochrane Central Register of Controlled Trials registers (1997-2009). INCLUSION CRITERIA a) effectiveness study of a lifestyle intervention targeted to ethnic minority populations living in a high income society; b) interventions included cultural adaptations and a control group that was exposed to the intervention without the cultural adaptation under study; c) primary outcome measures included smoking cessation, diet, or physical activity. RESULTS Out of 44904 hits, we identified 17 studies, all conducted in the United States. In five studies, specific cultural adaptations had a statistically significant effect on primary outcomes. The remaining studies showed no significant effects on primary outcomes, but some presented trends favorable for cultural adaptations. We observed that interventions incorporating a package of cultural adaptations, cultural adaptations that implied higher intensity and those incorporating family values were more likely to report statistically significant effects. Adaptations in smoking cessation interventions seem to be more effective than adaptations in interventions aimed at diet and physical activity. CONCLUSION This review indicates that culturally targeted behavioral interventions may be more effective if cultural adaptations are implemented as a package of adaptations, the adaptation includes family level, and where the adaptation results in a higher intensity of the intervention. More systematic experiments are needed in which the aim is to gain insight in the best mix of cultural adaptations among diverse populations in various settings, particularly outside the US.
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Affiliation(s)
- Vera Nierkens
- Department of Public Health, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Marieke A. Hartman
- Department of Public Health, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
- Department of Epidemiology, Documentation and Health Promotion, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Mary Nicolaou
- Department of Public Health, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Charlotte Vissenberg
- Department of Public Health, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Erik J. A. J. Beune
- Department of Public Health, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Karen Hosper
- Department of Public Health, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Irene G. van Valkengoed
- Department of Public Health, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Karien Stronks
- Department of Public Health, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
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Pérez M, Sefko JA, Ksiazek D, Golla B, Casey C, Margenthaler JA, Colditz G, Kreuter MW, Jeffe DB. A novel intervention using interactive technology and personal narratives to reduce cancer disparities: African American breast cancer survivor stories. J Cancer Surviv 2013; 8:21-30. [PMID: 24030573 DOI: 10.1007/s11764-013-0308-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 08/30/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE There has been a paucity of interventions developed for African American women to address persistent health disparities between African American and Caucasian breast cancer patients. We developed and piloted a technologically innovative, culturally targeted, cancer-communication intervention for African American breast cancer patients using African American breast cancer survivor stories. METHODS We rated 917 clips from a video library of survivors' stories for likability, clarity and length, and emotional impact (scaled responses) and categorized each clip by theme (Coping, Support and Relationships, Healthcare Experiences, Follow-up Care, Quality of Life, and Treatment Side Effects). We selected 207 clips told by 35 survivors (32-68 years old; 4-30 years after diagnosis), fitting one of 12 story topics, for inclusion in the interactive video program loaded onto a touch-screen computer. Videos can be searched by storyteller or story topics; stories with the strongest emotional impact were displayed first in the video program. RESULTS We pilot tested the video program with ten African American breast cancer survivors (mean age, 54; range 39-68 years), who, after training, watched videos and then evaluated the stories and video-program usability. Survivor stories were found to be "interesting and informative," and usability was rated highly. Participants identified with storytellers (e.g., they "think a lot like me," "have values like mine") and agreed that the stories convinced them to receive recommended surveillance mammograms. CONCLUSIONS This novel, cancer-communication technology using survivor stories was very favorably evaluated by breast cancer survivors and is now being tested in a randomized controlled clinical trial. IMPLICATIONS FOR CANCER SURVIVORS Breast cancer survivors can draw support and information from a variety of sources, including from other breast cancer survivors. We developed the survivor stories video program specifically for African American survivors to help improve their quality of life and adherence to follow-up care. Breast cancer survivors' experiences with treatment and living with cancer make them especially credible messengers of cancer information. Our novel, interactive technology is being tested in a randomized controlled trial and will be more broadly disseminated to reach a wider audience.
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Affiliation(s)
- Maria Pérez
- Washington University School of Medicine, 660 S. Euclid, Saint Louis, MO, 63110, USA,
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Campbell T, Dunt D, Fitzgerald JL, Gordon I. The impact of patient narratives on self-efficacy and self-care in Australians with type 2 diabetes: stage 1 results of a randomized trial. Health Promot Int 2013; 30:438-48. [PMID: 23985247 DOI: 10.1093/heapro/dat058] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
UNLABELLED A randomized-controlled trial (RCT) was conducted from September 2009 to June 2011. National Diabetes Services Scheme registrants diagnosed with type 2 diabetes and aged 30-70 years were invited to participate in a 3-week intervention programme with follow-up at 4 weeks and 6 months. Data were collected using self-report questionnaires in the participant's homes. The intervention group received diabetes factsheets and a DVD comprising patient stories (narratives) of type 2 diabetes management. The control group (CG) received factsheets only. The RCT evaluated the impact of patient narratives on the study outcomes, self-efficacy and self-care, using the Aust/English Diabetes Management Self-efficacy Scale and the Summary Diabetes Self-care Activities measure. Participants were randomly assigned to the intervention or CG using block randomization. The study was not blinded. Six hundred and seventy people enrolled into the study with 335 allocated to each group. At 4 weeks, data were available for 598 participants. t-tests were used to analyse the results. The mean difference between the groups for self-efficacy was 7.2 units (P < 0.001, 95% Confidence Interval (CI) 3.8, 10.7) favouring the intervention group. Change in self-care behaviours during the previous 7 days was also significantly greater for the intervention group: general diet (0.31 days, 95% CI 0.13, 0.48), specific diet (0.26 days, 95% CI 0.05, 0.46), exercise (0.51 days, 95% CI 0.23, 0.80), blood glucose (0.52 days, 95% CI 0.19, 0.85) and foot care (0.38 days, 95% CI 0.06, 0.71). Narrative communication shows promise as a valuable component of type 2 diabetes self-management programmes. REGISTRATION ACTRN 12609000210279.
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Affiliation(s)
- Tina Campbell
- Melbourne School of Population Health, Centre for Health Policy, Programs and Economics, The University of Melbourne, Level 4, 207 Bouverie Street, Melbourne, VIC, Australia
| | - D Dunt
- Melbourne School of Population Health, Centre for Health Policy, Programs and Economics, The University of Melbourne, Level 4, 207 Bouverie Street, Melbourne, VIC, Australia
| | - J L Fitzgerald
- School of Social and Political Sciences, The University of Melbourne, Melbourne, VIC Australia
| | - I Gordon
- Statistical Consulting Centre, The University of Melbourne, Melbourne, VIC, Australia
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Miller-Day M, Hecht ML. Narrative means to preventative ends: a narrative engagement framework for designing prevention interventions. HEALTH COMMUNICATION 2013; 28:657-70. [PMID: 23980613 PMCID: PMC3795942 DOI: 10.1080/10410236.2012.762861] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
This article describes a Narrative Engagement Framework (NEF) for guiding communication-based prevention efforts. This framework suggests that personal narratives have distinctive capabilities in prevention. The article discusses the concept of narrative, links narrative to prevention, and discusses the central role of youth in developing narrative interventions. As illustration, the authors describe how the NEF is applied in the keepin' it REAL adolescent drug prevention curriculum, pose theoretical directions, and offer suggestions for future work in prevention communication.
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