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Woudstra AJ, Suurmond J. How narratives influence colorectal cancer screening decision making and uptake: A realist review. Health Expect 2019; 22:327-337. [PMID: 31025444 PMCID: PMC6543268 DOI: 10.1111/hex.12892] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 02/19/2019] [Accepted: 03/24/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Although narratives have been found to affect decisions about preventive behaviours, including participation in cancer screening, the underlying mechanisms of narratives remain unclear. OBJECTIVE The purpose of this study was to summarize and synthesize existing literature on narrative interventions in the context of colorectal cancer screening. Our main research question was as follows: How, when and for whom do narratives work context of decision making about colorectal cancer screening participation? METHODS We undertook a realist review to collect evidence on narratives in the context of colorectal cancer screening. A search of the literature was performed in Embase, MEDLINE/PubMed, Cinahl and PsycINFO. We included empirical evaluations (qualitative or quantitative) of narrative interventions. In total, 15 studies met the inclusion criteria. A content-based taxonomy of patient narrative types in decision aids formed the basis for our initial programme theory. MAIN RESULT We identified four mechanisms: (a) process narratives that address perceived barriers towards screening lead to improved affective forecasting, (b) experience narratives that demonstrate the screening procedure lead to increased self-efficacy, (c) experience narratives that depict experiences from similar others lead to more engagement and (d) outcome narratives that focus on outcomes of colorectal cancer (CRC) screening decision decrease or increase fear of colorectal cancer. The evidence was limited on which narrative type may facilitate or bias informed decision making in colorectal cancer screening. DISCUSSION AND CONCLUSION The findings indicate the importance of more detailed descriptions of narrative interventions in order to understand how mechanisms may facilitate or bias informed decision making in colorectal cancer screening.
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Affiliation(s)
- Anke Judith Woudstra
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Jeanine Suurmond
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Gavaruzzi T, Sarlo M, Giandomenico F, Rumiati R, Polato F, De Lazzari F, Lotto L. Assessing emotions conveyed and elicited by patient narratives and their impact on intention to participate in colorectal cancer screening: A psychophysiological investigation. PLoS One 2018; 13:e0199882. [PMID: 29953535 PMCID: PMC6023155 DOI: 10.1371/journal.pone.0199882] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 06/17/2018] [Indexed: 12/22/2022] Open
Abstract
In the context of colorectal cancer screening, we aimed to compare the effectiveness of different emotion-laden narratives, to investigate the specific emotions elicited at both subjective and physiological levels, and to test the effects of emotions explicitly expressed by the narrative character. Study 1 used a between-participants design comparing four conditions: relief-based narrative, regret-based narrative, control (test-uptake only) narrative, and standard invitation material (no-narrative condition). Study 2 used a mixed design, with the narrative content as a within-participants factor and whether emotions were expressed by the narrative character or not as between-participants factor. The main outcome measures were: intention to undergo testing (Studies 1 and 2), knowledge, risk perception, proportion of informed choices (Study 1), subjective emotional responses, changes in skin conductance, heart rate, and corrugator muscle activity (Study 2). In Study 1, relative to the non-narrative condition (51%), only the relief-based narrative significantly increased intention to undergo testing (86%). Relative to the standard invitation material, the narrative conditions did not decrease knowledge, alter risk perception, or decrease the proportion of informed choices. In Study 2, the relief-based narrative elicited the lowest self-reported negative affect, and received greater implicit attention, as suggested by the larger heart rate decrease. Making the emotions experienced by the narrative character explicit decreased negative affect, as indicated by the lower skin conductance and corrugator responses during reading. Our findings provide support for the use of a relief-based narrative with emotions expressed by the character in addition to the standard information material to promote colorectal cancer screening.
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Affiliation(s)
- Teresa Gavaruzzi
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
- * E-mail:
| | - Michela Sarlo
- Department of General Psychology, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Francesca Giandomenico
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Rino Rumiati
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | | | | | - Lorella Lotto
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
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Choi MJ, Kim SH, Lee S, Kwon BC, Yi JS, Choo J, Huh J. Toward Predicting Social Support Needs in Online Health Social Networks. J Med Internet Res 2017; 19:e272. [PMID: 28768609 PMCID: PMC5559652 DOI: 10.2196/jmir.7660] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/05/2017] [Accepted: 05/23/2017] [Indexed: 01/05/2023] Open
Abstract
Background While online health social networks (OHSNs) serve as an effective platform for patients to fulfill their various social support needs, predicting the needs of users and providing tailored information remains a challenge. Objective The objective of this study was to discriminate important features for identifying users’ social support needs based on knowledge gathered from survey data. This study also provides guidelines for a technical framework, which can be used to predict users’ social support needs based on raw data collected from OHSNs. Methods We initially conducted a Web-based survey with 184 OHSN users. From this survey data, we extracted 34 features based on 5 categories: (1) demographics, (2) reading behavior, (3) posting behavior, (4) perceived roles in OHSNs, and (5) values sought in OHSNs. Features from the first 4 categories were used as variables for binary classification. For the prediction outcomes, we used features from the last category: the needs for emotional support, experience-based information, unconventional information, and medical facts. We compared 5 binary classifier algorithms: gradient boosting tree, random forest, decision tree, support vector machines, and logistic regression. We then calculated the scores of the area under the receiver operating characteristic (ROC) curve (AUC) to understand the comparative effectiveness of the used features. Results The best performance was AUC scores of 0.89 for predicting users seeking emotional support, 0.86 for experience-based information, 0.80 for unconventional information, and 0.83 for medical facts. With the gradient boosting tree as our best performing model, we analyzed the strength of individual features in predicting one’s social support need. Among other discoveries, we found that users seeking emotional support tend to post more in OHSNs compared with others. Conclusions We developed an initial framework for automatically predicting social support needs in OHSNs using survey data. Future work should involve nonsurvey data to evaluate the feasibility of the framework. Our study contributes to providing personalized social support in OHSNs.
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Affiliation(s)
- Min-Je Choi
- Department of Computer Science and Engineering, Korea University, Seoul, Republic Of Korea
| | - Sung-Hee Kim
- Department of Industrial ICT Engineering, Dong-eui University, Busan, Republic Of Korea
| | - Sukwon Lee
- Department of Industrial Engineering, Purdue University, West Lafayette, IN, United States
| | - Bum Chul Kwon
- IBM Thomas J. Watson Research Center, Yorktown Heights, NY, United States
| | - Ji Soo Yi
- Samsung Electronics Co., Ltd., Seoul, Republic Of Korea
| | - Jaegul Choo
- Department of Computer Science and Engineering, Korea University, Seoul, Republic Of Korea
| | - Jina Huh
- Division of Biomedical Informatics, University of California San Diego, San Diego, CA, United States
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Bennett KF, von Wagner C, Robb KA. Supplementing factual information with patient narratives in the cancer screening context: a qualitative study of acceptability and preferences. Health Expect 2015; 18:2032-41. [PMID: 25728262 PMCID: PMC4737095 DOI: 10.1111/hex.12357] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2015] [Indexed: 11/29/2022] Open
Abstract
Objective To explore people's responses to narrative information in the context of colorectal cancer screening. Design Nineteen in‐depth interviews were conducted with men and women (aged 45–59). Participants were given two types of colorectal screening information to read: factual and narrative. Participants gave their views on both types of information. Data were analysed using Framework Analysis. Results The most frequent responses to the narrative information were that they were reassuring, made colorectal screening more vivid, participants could relate to the people in the stories and they liked the range of narratives presented. Despite the narrative information being seen as more persuasive by some, this was not regarded as manipulative or negative. Both types of information were seen as equally credible. Participants felt a combination of facts and narratives would be useful when considering an offer of colorectal cancer screening. Conclusion Overall, participants were positive about the addition of narrative information to the currently provided factual information about colorectal cancer screening. Supplementing existing factual information with narrative information may provide participants with a more complete understanding of participation in colorectal cancer screening when considering an offer to be screened.
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Affiliation(s)
| | - Christian von Wagner
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Kathryn A Robb
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Koskan A, Klasko L, Davis SN, Gwede CK, Wells KJ, Kumar A, Lopez N, Meade CD. Use and taxonomy of social media in cancer-related research: a systematic review. Am J Public Health 2014; 104:e20-37. [PMID: 24832403 DOI: 10.2105/ajph.2014.301980] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Little is known about how social media are used in cancer care. We conducted a systematic review of the use and taxonomy of social media in cancer-related studies, in PubMed, Web of Knowledge, CINAHL, and Google Scholar. We located 1350 articles published through October 2013; 69 met study inclusion criteria. Early research (1996-2007) was predominantly descriptive studies of online forums. Later, researchers began analyzing blogs, videos shared on YouTube, and social networking sites. Most studies (n = 62) were descriptive, and only 7 reported intervention studies published since 2010. Future research should include more intervention studies to determine how social media can influence behavior, and more empirical research is needed on how social media may be used to reduce health disparities.
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Affiliation(s)
- Alexis Koskan
- At the time of the study, the authors were with Moffitt Cancer Center, Tampa, FL
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Kraschnewski JL, Hwang KO, George DR, Lehman EB, Sciamanna CN. Feasibility of utilising an all-volunteer workforce as a disruptive innovation for the US obesity epidemic. Obes Res Clin Pract 2014; 8:e488-96. [PMID: 25263838 DOI: 10.1016/j.orcp.2014.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 10/03/2013] [Accepted: 01/07/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES As the prevalence of obesity in US adults continues to increase, addressing weight control will require an effective, lower-cost intervention. A model for delivering free peer-to-peer counselling has the potential to create a paradigm shift in the way weight and other chronic illnesses are addressed in the US. The objective of this study is to understand the potential for utilising successful peer volunteers as counsellors in weight control programmes and as a possible intervention strategy to address the global obesity epidemic in a cost-effective manner. STUDY DESIGN This cross-sectional study surveyed a nationwide panel of US adults (n=806) in 2010. METHODS We created survey items to identify participant interest in three specific types of weight control programmes: a free programme led by successful peers, a paid programme led by successful peers and a programme led by trained paid professionals. Statistical analysis was conducted in 2011. Logistic regression was used to adjust for the effect of potential confounders on participant interest in different weight control programmes and willingness to volunteer. RESULTS More than three times as many subjects (27.4% vs. 8.3%) were interested in the free peer-led programme versus the expert-led paid option. Of participants who had ever had successful weight loss, 15% were interested in volunteering to help others lose weight. CONCLUSIONS Individuals appear to be willing to both attend and conduct peer volunteer-led weight control groups. Further research is necessary to develop and test interventions to assess the effectiveness of such interventions.
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Affiliation(s)
- Jennifer L Kraschnewski
- Department of Medicine, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, United States; Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States.
| | - Kevin O Hwang
- Department of Medicine, University of Texas Medical School at Houston, Houston, TX, United States
| | - Daniel R George
- Department of Humanities, Penn State College of Medicine, United States
| | - Erik B Lehman
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Christopher N Sciamanna
- Department of Medicine, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, United States; Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
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Cutrona SL, Roblin DW, Wagner JL, Gaglio B, Williams AE, Torres Stone R, Field TS, Mazor KM. Adult Willingness to Use Email and Social Media for Peer-to-Peer Cancer Screening Communication: Quantitative Interview Study. JMIR Res Protoc 2013; 2:e52. [PMID: 24287495 PMCID: PMC3868965 DOI: 10.2196/resprot.2886] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 11/08/2013] [Accepted: 11/08/2013] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adults over age 40 are increasing their use of email and social media, raising interest in use of peer-to-peer Internet-based messaging to promote cancer screening. OBJECTIVE The objective of our study was to assess current practices and attitudes toward use of email and other e-communication for peer-to-peer dialogues on cancer screening. METHODS We conducted in-person interviews with 438 insured adults ages 42-73 in Georgia, Hawaii, and Massachusetts. Participants reported on use of email and other e-communication including social media to discuss with peers routine health topics including breast and colorectal cancer (CRC). We ascertained willingness to share personal CRC screening experiences via conversation, postcard, email, or other e-communication. Health literacy scores were measured. RESULTS Email had been used by one-third (33.8%, 148/438) to discuss routine health topics, by 14.6% (64/438) to discuss breast cancer screening, and by 12.6% (55/438) to discuss CRC screening. Other e-communication was used to discuss routine health topics (11.6%, 51/438), screening for breast cancer (3.9%, 17/438), and CRC (2.3%, 10/438). In the preceding week, 84.5% (370/438) of participants had used email, 55.9% (245/438) had used e-communication of some type; 44.3% (194/438) text, 32.9% (144/438) Facebook, 12.3% (54/438) instant message, 7.1% (31/438) video chat, and 4.8% (21/438) Twitter. Many participants were willing to share their CRC screening experiences via email (32.4%, 142/438 might be willing; 36.3%, 159/438 very willing) and via other e-communication (15.8%, 69/438 might be willing; 14.4%, 63/438 very willing). Individuals willing to send CRC screening emails scored significantly higher on tests of health literacy compared to those willing to send only postcards (P<.001). CONCLUSIONS Many adults are willing to use email and e-communication to promote cancer screening to peers. Optimal approaches for encouraging peer-to-peer transmission of accurate and appropriate cancer screening messages must be studied.
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Affiliation(s)
- Sarah L Cutrona
- University of Massachusetts Medical School, Worcester, MA, United States.
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Online narratives and peer support for colorectal cancer screening: a pilot randomized trial. Am J Prev Med 2013; 45:98-107. [PMID: 23790994 DOI: 10.1016/j.amepre.2013.02.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 12/03/2012] [Accepted: 02/25/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND Delivering personal narratives and peer support for CRC screening in an online weight-loss community could be an efficient approach to engaging individuals at increased risk, because obesity is associated with excess colorectal cancer (CRC) mortality and lower screening rates. PURPOSE Evaluate user engagement and impact of narratives and peer support for promoting CRC screening in an online weight-loss community. DESIGN Pilot randomized trial. SETTING/PARTICIPANTS Members of an online weight-loss community who were not up-to-date with CRC screening were enrolled in the study in 2011. INTERVENTION Basic and Enhanced groups (n=153 each) both received education. The Enhanced group also received narratives and peer support for CRC screening in online forums. MAIN OUTCOME MEASURES The main measures were user engagement, psychosocial outcomes, and self-report CRC screening at 6 months. Analyses were conducted with (1) the full sample of participants and (2) a minimum dose sample of those who participated in their assigned intervention to a minimum degree. Analyses were completed in 2012. RESULTS Participants were mostly female (92%) with a mean age of 56 years. More than 90% in both groups viewed the educational information. Only 57% in the Enhanced group joined the online team. The Enhanced group had greater improvement in motivation for screening than the Basic group at 1 month (p=0.03). In the full sample, there was no difference in CRC screening at 6 months (Enhanced 19% vs Basic 16%, adjusted OR=1.33, 95% CI=0.73, 2.42). In the minimum dose sample, fecal occult blood testing was higher in the Enhanced (14%) vs Basic (7%) group (adjusted OR=2.49, 95% CI=1.01, 6.17). CONCLUSIONS Although no between-group differences in CRC screening were seen at 6 months, this study did demonstrate that it is feasible to deploy a narrative and peer support intervention for CRC screening in a randomized trial among members of an online community. However, modifications are needed to improve user engagement. TRIAL REGISTRATION This study is registered at ClinicalTrials.gov NCT01411826.
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