Saying the Right Thing at the Right Time: Knowing Your Audience for Health Communication Messages

American Indian Response to Targeted Cancer Education and Outreach Materials

Authors:

Meggan McCann (Presenter)
American Indian Cancer Foundation

Laura Sioux Roberts, American Indian Cancer Foundation
Marco Yzer, PhD, University of Minnesota; Rebekah Nagler, PhD, University of Minnesota
Kris Rhodes, MPH, American Indian Cancer Foundation
Jessica Harjo, MA, American Indian Cancer Foundation
Susan LoRusso, MA, University of Minnesota
Sarah Gollust, PhD, University of Minnesota

Public Health Statement: American Indians in the Northern Plains face significant cancer disparities, including for HPV cancers. American Indians parents have expressed a desire for culturally specific HPV education materials in qualitative studies. This research explored the effects of the cultural cues on HPV vaccination perceptions among parents and guardians of American Indian youth.

Purpose: To evaluate the extent to which American Indian visual cultural cues affect perceived message effectiveness in an HPV vaccine educational message

Methods/Approach: An experimental design using three message conditions that differed in the extent to which American Indian cultural cues were represented (“control,” “moderate,” and “enhanced”) measured different perceptions of identification with the portrayed youth. Three hundred parents of AI children were recruited in community locations to take surveys on tablets. A regression analysis was used to identify the extent to which AI parents’ intention to have their children vaccinated against HPV was a function of attitudinal, normative and control perceptions.

Results: As intended, the three educational messages induced different perceptions of identification with the portrayed youth. Participants thought the two American Indian youth messages were equally and strongly similar to their children compared to the control image. Cultural cues had a clear, strong effect on perceptions of effectiveness. Perceptions of similarity correlated positively with message evaluations; the more the pictured youth were perceived as similar to subjects’ children, the more convincing and pleasant messages were perceived to be.

Conclusions/Implications: Culturally specific messaging in an important strategy in addressing cancer disparities. The results show that the moderate and enhanced cues were equally effective. This provides useful data for future design approaches in the design of cancer messages and image content created specifically for American Indians.

Patient-Centered Communication in Cancer Care Settings: Findings from a Survey of Colorectal Cancer Patients

Authors:

Katherine Treiman (Presenter)
RTI International

Lauren McCormack, RTI International
Carla Bann, RTI International
Laura Wagner, RTI International
Rebecca Moultrie, RTI International
Bryce Reeve, Gillings School of Public Health, UNC

Public Health Statement: Patient-centered communication (PCC) helps cancer patients make healthcare decisions, handle the emotional impact of their diagnosis, understand complex information, deal with uncertainty, and build trusting relationships with providers. PCC contributes directly and indirectly to patient outcomes, including self-efficacy, psychological adjustment, and health-related quality of life.

Purpose: The study assessed PCC in the cancer setting using a statewide database of patients. We measured how differences in perceived communication experiences varied by patient socio-demographic and health characteristics.

Methods/Approach: Adults with colorectal cancer in North Carolina completed a survey 2–3 months post-diagnosis. Respondents answered questions about six PCC domains: Exchanging Information, Making Decisions, Fostering Healing Relationships, Managing Uncertainty, Responding to Emotions, and Enabling Patient Self-Management. Scores ranged from 1 to 5, with 5 representing excellent PCC.

Results: A total of 501 patients responded to the survey (response rate 38%); 80% had colon cancer and 17% rectal cancer. Overall, respondents rated communication with their providers highly (mean (SD)=4.12 (0.81)). Ratings were highest for the Fostering Healing Relationships domain (mean (SD)=4.38 (0.65)) and lowest for the Enabling Self-Management (mean (SD)=3.87 (0.93)) and Managing Uncertainty (mean (SD)=3.89 (0.96)) domains. Respondents who were more educated, white, older, and in poor physical and mental health reported worse communication experiences relative to their counterparts. Compared to respondents with private insurance, those on Medicaid or with no insurance had less favorable assessments.

Conclusions/Implications: Interventions are needed to ensure that all cancer patients benefit from high-quality communication with their providers. Effective approaches are especially needed to improve PCC for vulnerable subgroups

Using the Integrative Model to Predict Protective Behaviors Around Air Quality: The Role of Information Exposure on Cancer Prevention Behaviors

Authors:

Steven Ramondt (Presenter)
University of California, Merced

A. Susana Ramirez, University of California, Merced

Public Health Statement: Air pollution is the single largest environmental health risk, a carcinogen with a wide range of adverse health outcomes. Although a public health approach requires structural change to reduce worldwide air pollution levels and associated health risks, individuals can take preventive actions to mitigate their own exposure and risks. However, little is known about what drives people to reduce risk from poor air quality.

Purpose: This study examined to what extent emerging adults actively seek or come across (scan) air quality information from diverse sources. In addition, we used the integrative model of behavioral prediction to identify factors that determine engagement in behaviors that reduce exposure to harmful air quality.

Methods/Approach: Structural equation modeling (SEM) using an emerging adult (n=938; 59.5% Hispanic/Latino) sample from one of the most polluted regions in the United States.

Results: Only 25.5% of the sample actively sought information about air quality. Almost 80% of participants reported scanning air quality information, with websites, televise and radio, and interpersonal being the primary sources. The SEM model showed that attitudes, self-efficacy, and social norms predicted intention, with perceived social norms being the primary determinant of behavioral intention. Both information seeking and scanning positively predicted social norms.

Conclusions/Implications: The public information environment plays a salient role in increasing environmental health risk awareness and guiding protective behaviors. These findings explain the underlying psychological mechanisms driving risk-reducing air quality behavior and the effect of information exposure on these mechanisms. In addition, these results suggest specific opportunities for cancer risk communication to improve individual protective behaviors.

Renewed National Consensus on the Recommended Core Content for Sun Safety Public Education Messages in Canada

Authors:

Maria Chu (Presenter)
Cancer Care Ontario

Loraine Marrett, Cancer Care Ontario
John Atkinson, Canadian Cancer Society
Robert Nuttall, Canadian Cancer Society
Gillian Bromfield, Canadian Cancer Society
Larry Hershfield, University of Toronto
Cheryl Rosen, Toronto Western Hospital, University Health Network Hospitals, and Mount Sinai Hospital

Public Health Statement: Overexposure to the sun and other sources of ultraviolet radiation (UVR), such as tanning equipment, can cause skin cancer and increase the risk of some eye diseases. Surveys conducted in 1996 and 2006 suggest that an increasing number of Canadians are spending more time in the sun without ensuring protection against harmful UVR exposure. The annual number of new cases of melanoma, the most deadly form of skin cancer, has also been increasing. Consensus on information for sun safety public education messages among organizations across Canada was last achieved in 1994. The science on UVR protection has since evolved and updates by organizations have taken place inconsistently. Research on cancer prevention practices suggests that when people are presented with ambiguous information, the likelihood of adopting these practices decreases, supporting the need for consistent messages in health promotion.

Purpose: As a first step to addressing increased UVR exposure among Canadians, work to achieve stakeholder consensus on recommended personal protection practices was undertaken.

Methods/Approach: Member organizations with the Ontario Sun Safety Working Group initiated the national consensus process using draft recommendation statements developed by a scientific panel. They convened a National Steering Committee and engaged a health communications expert to develop and implement the consensus process. The process involved identifying organizations with a mandate to promote sun safety to the public; inviting representatives from these organizations to attend a workshop; conducting pre-workshop surveys with representatives to identify areas of disagreement on statements, the workshop and a post-workshop confirmation survey. A total of 28 organizations participated.

Results: The result of the consensus process is the updated Recommended Core Content for Sun Safety Messages in Canada. Four groups of statements comprise the new content: Key Facts, Primary Recommended Protective Action Statements, Additional Recommended Protective Action Statements, and Tips for Implementing the Primary Protective Actions. Organizations are encouraged to adopt, at minimum, the Primary Recommended Protective Action Statements as the basis for public messaging.

Conclusions/Implications: The recommended core content establishes a common understanding of what is needed for effective personal sun protection. The underlying expectation is that, as a key next step, content will be tailored for different subpopulations and health promotion campaigns.