Elisia L. Cohen

What makes cancer survivor stories work? An empirical study among African American women

IntroductionCancer survivors play a vital role in cancer control as messengers of hope and information, and advocates for prevention and screening. Understanding what makes survivor stories effective can enhance survivor-delivered programs and interventions.MethodsBy random assignment and using a cross-classified design, 200 African American women viewed videotaped stories (n = 300) from 36 African American breast cancer survivors. Analyses examined effects of story attributes (narrative quality, health message strength), participant characteristics (ways of knowing, experience with breast cancer) and identification with the survivor on women’s: (1) level of engagement in the story; (2) positive thoughts about the story; and, (3) remembering key messages about breast cancer and mammography in the story.ResultsParticipant characteristics were significant predictors of all three study outcomes, accounting for 27.8, 2.6 and 22.2% of their total variance, respectively. In comparison, the variability in these outcomes that could be attributed to differences in the stories was small (0.6, 1.1 and 2%, respectively). The effects of participant characteristics on level of engagement and positive thoughts were mediated by identification with the survivor.ConclusionsThe best predictor of a woman becoming engaged in a breast cancer survivor’s story and having positive thoughts about the story was whether she liked the survivor and viewed her as similar to herself (i.e., identification).Implications for cancer survivorsSurvivor stories may be most effective when audience members identify with the survivor. Finding key characteristics that can reliably match the two will advance cancer communication science and practice.

Anti-smoking Media Campaign messages: Theory and practice

This study examined televised anti-smoking advertisements that were designed to discourage adult and teen smoking. A content analysis of 399 television advertisements catalogued in the Media Campaign Resource Center (MCRC) database were evaluated to determine (a) whether the advertising content reflected core health communication theories used in the design of health campaign messages to change behavior and (b) the affective presentation of tobacco-control advertisements aimed to decrease smoking. The results revealed that anti-smoking advertising relied overwhelmingly on appeals to attitudes. Although the benefits of not smoking were mentioned in 61% of advertisements, barriers were mentioned in only 17% of advertisements. Advertisements emphasized the consequences of smoking more than the viewers self-efficacy. Finally, advertisements were more likely to use informational and humor appeals, rather than sadness, fear, or anger appeals. The research identifies the types of advertisements that are most likely to be utilized and underutilized in national and statewide anti-smoking advertising campaigns catalogued in the MCRC database.

Cancer Coverage in General-Audience and Black Newspapers

This article presents findings from the first study of cancer news coverage in a national sample of Black and general-audience newspapers. We compared 2,439 health news stories from 23 weekly Black newspapers to 2,767 health news stories from a constructed week sample of 12 daily general-audience newspapers, both collected between April 1, 2004, and March 31, 2005. Analyses examined differences in the amount and nature of cancer coverage, specifically cancer sites, disparities, localization, and personally mobilizing health information for readers. Cancer was the main topic in a higher proportion of health stories in Black newspapers than in general-audience newspapers (13.6% vs. 9.6%; p = .001). Among cancer stories, those in Black newspapers had more localization (p = .004), disparity information (p = .001), and personal mobilization information (p = .001) than those in general-audience newspapers. In neither type of newspaper did the distribution of stories by cancer site accurately reflect the impact of different cancers on population mortality.

Internet connectedness before and after September 11 2001

Abstract Based on survey data gathered before and after September 11, 2001 (‘9/11’), this study examines the relationship between ‘internet connectedness’ and communicative actions after September 11 2001. The study found that: (1) people heightened their dependency relations with traditional mass media after September 11, regardless of whether or not they had an internet connection; (2) ‘internet high-connectors’ intensified their internet connections, while ‘internet low-connectors’ decreased the intensity of their internet connections; and (3) internet high-connectors participated in a broader range of civic activities in response to September 11 than did internet low-and non-connectors.

Young Women’s Perspectives on Cervical Cancer Prevention in Appalachian Kentucky

Human papillomavirus (HPV) vaccination coupled with routine Papanicolaou (Pap) tests can prevent pervasive HPV infections causing cervical cancer. However, both HPV vaccination rates and Pap testing rates in Appalachian Kentucky are lower among all age groups than the rest of the United States. We recruited 19 young women residing in Appalachian Kentucky from university-based and rural clinical settings for group and individual interviews. After considering an integrated behavioral framework, we illustrate these women’s perspectives by detailing five themes, including (a) experiential beliefs pose barriers to performing behaviors, (b) three vaccine doses complicate vaccination intention, (c) women have misunderstandings about HPV and the HPV vaccination function, (d) normative influences cue action (and inaction), and (e) specific environmental and contextual barriers exist to performing cervical cancer prevention behaviors in Appalachian Kentucky. These findings related to cervical cancer prevention in Appalachian Kentucky have implications for health-message design and clinical practice.

How Much Is Enough? New Recommendations for Using Constructed Week Sampling in Newspaper Content Analysis of Health Stories

Researchers frequently use constructed week samples to approximate content for larger populations of textual data in content analysis projects. To date, this sampling method has not been validated in longitudinal contexts necessary for the conduct of large-scale health communication research. This study uses Monte Carlo bootstrap sampling to determine the number of constructed weeks necessary to accurately estimate one- and five-year population values for different types of variables in a quantitative content analysis. Five years (1999–2004) of four different daily newspapers were coded for four variables that varied on type (count vs. rating), amount of missing data, and distribution (normal vs. nonnormal). Results suggest that sampling a minimum of six constructed weeks was most efficient for both time frames. Missing data lowers sampling precision, although a correction can be calculated if the amount of missing data can be estimated. Using an efficient method of sampling newspapers such as constructed week sampling can help communication researchers to more easily study health coverage in the media.

One nation under radio: digital and public memory after September 11:

National Public Radio’s Sonic Memorial project leveraged the opportunities of digital multimedia convergence to create a national aural memorial of the September 11 2001 attacks on the World Trade Center. Not only did the ubiquity of digital technology empower listeners to act as producers in submitting texts to the Memorial, but it also allowed the Sonic Memorial to bridge radio and new media environments through the creation of a lasting memorial website at www.sonicmemorial.com. While unique in its focus on participatory vernacular aural remembrance, the Sonic Memorial nevertheless shares many attributes of traditional national memorials in its focus on making sense of national tragedy. Despite its uniqueness, the Sonic Memorial privileges certain stories, leaving others unvoiced in its montage of remembrance.

An Intervention to Increase Compliance with a Tobacco-Free University Policy:

Purpose. To test the effects of a population-based self-efficacy message card campaign on compliance with a tobacco-free campus policy. Setting. This study was conducted at a large public university in the South. Subjects. Three hundred twelve observational periods at 39 campus sites. Intervention. The message card campaign, based on the Theory of Planned Behavior, consisted of distributing approximately 6000 efficacy-enhancing cards over 3 days. The intent of the cards was to increase awareness of the policy and resources available to help individuals stop smoking or remain comfortable while on campus. Measures. Policy compliance was measured using the Tobacco-Free Compliance Assessment Tool. Field notes were used to assess campaign reaction. Analysis. Mann-Whitney U-test was conducted to compare number of cigarette butts in hot spot areas before and after the intervention. A rate ratio was also calculated using Geographic Information System (GIS) mapping software to compare cigarette butts collected per day before and after the intervention at each of the study sites. Results. The median number of cigarette butts per day after the intervention was significantly lower than before the intervention (1.9 vs. 4.7, χ2: 8.1, p = .004). Eighteen sites (66.6%) had a post-pre ratio of .11 to .75, indicating a decrease in cigarette butts per day. Conclusion. An efficacy-enhancing message card campaign shows promise in improving compliance with tobacco-free campus policies.

Alcohol and Tobacco Advertising in Black and General Audience Newspapers: Targeting with Message Cues?

This study content analyzed 928 tobacco- and alcohol-related advertisements from a 3-year national sample of Black (n = 24) and general audience (n = 11) newspapers from 24 U.S. cities. The authors compared the frequency of tobacco and alcohol product and control advertising in Black versus general audience newspapers, as well as the presence of 5 message cues: model ethnicity, presence of health official, referral to resources, personal behavior mobilization, and localization. Results within health issues show that Black newspapers had more alcohol product advertising than did general audience newspapers. In contrast, Black newspapers had less alcohol and tobacco control advertising than general audience newspapers. Black newspapers’ tobacco/alcohol product advertisements had more African American models than did general audience newspapers’ tobacco/alcohol advertising, whereas general audience newspapers’ tobacco control advertisements were significantly more likely to feature public health officials than ads in Black newspapers. Fewer message cues such as personal behavior mobilization, referral to resources, and localization were present in Black versus general audience newspapers. Results suggest that Black newspapers may have greater dependency than do general audience newspapers on these risk-related advertisements that target African American consumers. Given the current advertising environment, public health initiatives are needed to counter unhealthy alcohol product advertising messages that target vulnerable populations.

Naming and Claiming Cancer among African American Women: An Application of Problematic Integration Theory

This study examines how a sample of African American women understands the uncertainties fundamental to cancer risk communication. Utilizing data from four focus groups, Problematic Integration (PI) theory is applied as an interpretive lens for illustrating their felt difficulties of talking openly about cancer and breast cancer in everyday life. The women describe worry about cancer and its prevalence among African American women; ambivalence and uncertainty; belief that what is not uncertain is certain and awful; fear and avoidance; contradictions in “claiming” and “rebuking” cancer; and hopefulness.