Lauren B. Frank

Narrative versus Nonnarrative: The Role of Identification, Transportation, and Emotion in Reducing Health Disparities

This research empirically tests whether using a fictional narrative produces a greater impact on health-related knowledge, attitudes, and behavioral intention than presenting the identical information in a more traditional, nonfiction, non-narrative format. European American, Mexican American, and African American women (N = 758) were surveyed before and after viewing either a narrative or non-narrative cervical cancer-related film. The narrative was more effective in increasing cervical cancer-related knowledge and attitudes. Moreover, in response to the narrative featuring Latinas, Mexican Americans were most transported, identified most with the characters, and experienced the strongest emotions. Regressions revealed that transportation, identification with specific characters, and emotion each contributed to shifts in knowledge, attitudes, and behavioral intentions. Thus, narrative formats may provide a valuable tool in reducing health disparities.

Advancing Research in Organizational Communication Through Quantitative Methodology

This article showcases current best practices in quantitative organizational communication research. We emphasize their value in exploring issues of the day and their relation to other research approaches. Materials are presented around four themes: systematic development and validation of measures, including the use of mixed methods; multiple levels of analysis; the study of change and development over time; and relationships among people, units, organizations, and meanings.

Conversation and Compliance: Role of Interpersonal Discussion and Social Norms in Public Communication Campaigns

This study explores the role of interpersonal discussion and social norms in a public health campaign, the BBC Condom Normalization Campaign, designed to promote conversation and change the public perception of condom use in India. Drawing upon the integrative model of behavioral prediction, attitudes, self-efficacy, subjective norms, and descriptive norms were predicted to relate to behavioral intentions to use condoms. It is important to note that the valence of discussion was hypothesized to relate to each of these more proximal predictors. The authors used structural equation modeling to test the model on 3 separate samples of Indian men between the ages of 15 and 49 years: (a) high-risk men who had sex with nonspouses; (b) low-risk, sexually inactive, unmarried men; and (c) low-risk, monogamous, married men. Results were similar for low- and high-risk audiences, with valence of discussion about condoms predicting condom-related attitudes, self-efficacy, and subjective and descriptive social norms with respect to condom use, which, in turn, predicted behavioral intent to use condoms. These findings underscore the need to take not only the frequency but also the valence of interpersonal discussion into account when assessing the effect of health campaigns. Implications for theory and design of future public communication campaigns are explored.

The Ability of Narrative Communication to Address Health-related Social Norms

Abstract: Social norms are an important predictor of health behavior and have been targeted by a variety of health communication campaigns. However, these campaigns often encounter challenges related to the socially specific context in which norms exist: specifically, the extent to which the target population identifies with the specific reference group depicted and the extent to which the target population believes the campaign’s message. We argue that because of its capacity to effect identification among viewers, narrative communication is particularly appropriate for impacting social norms and, consequently, behavioral intention. This manuscript presents the results of a randomized trial testing the effectiveness of two films – one narrative, one non-narrative – in changing perceived social norms and behavioral intention regarding Pap testing to detect cervical cancer. Results of the study indicate that the narrative film was in fact more effective at producing positive changes in perceived norms and intention.

Tamale Lesson: A case study of a narrative health communication intervention

Abstract Cervical cancer is the third most common type of cancer in women globally. Latinas carry a disproportionate burden of this disease. In the United States, when compared with non-Hispanic Whites, Latinas endure much higher incidence rates (13.86 vs. 7.70 per 100 000) with mortality rates 1.5 times greater than for non-Hispanic White women. In order to address this disparity, a multidisciplinary team engaged in a study to test the effectiveness of a narrative, developed in culturally specific ways as a behavioral change communication tool. This case study presents lessons learned from Tamale Lesson, a narrative health communication intervention aimed at Mexican-American women that promotes cervical cancer screening (via Pap test) and prevention (via use of the Human Papillomavirus vaccine). Mexican American women who viewed Tamale Lesson showed a significant increase in cervical cancer screening, reducing a disparities in cancer screening found at baseline. This case study highlights the benefits of creating a culturally grounded narrative intervention, and underscores the powerful potential of narrative/storytelling in eliminating health disparities in the United States and around the world.

Comparing the Relative Efficacy of Narrative vs Nonnarrative Health Messages in Reducing Health Disparities Using a Randomized Trial.

OBJECTIVES We compared the relative efficacy of a fictional narrative film to a more traditional nonnarrative film in conveying the same health information. METHODS We used a random digit dial procedure to survey the cervical cancer-related knowledge, attitudes, and behavior of non-Hispanic White, Mexican American, and African American women, aged 25 to 45 years, living in Los Angeles, California, from 2011 to 2012. Participants (n = 704) were randomly assigned to view either a narrative or nonnarrative film containing the same information about how cervical cancer could be prevented or detected, and they were re-contacted 2 weeks and 6 months later. RESULTS At 2 weeks, both films produced a significant increase in cervical cancer-related knowledge and attitudes, but these effects were significantly higher for the narrative film. At 6 months, viewers of both films retained greater than baseline knowledge and more positive attitudes toward Papanicolaou (Pap) tests, but women who saw the narrative were significantly more likely to have had or scheduled a Pap test. The narrative was particularly effective for Mexican American women, eliminating cervical cancer screening disparities found at baseline. CONCLUSIONS Narratives might prove to be a useful tool for reducing health disparities.

Telling Stories, Saving Lives: Creating Narrative Health Messages

Increasingly, health communication practitioners are exploring the use of narrative storytelling to convey health information. For this study, a narrative film was produced to provide information about the human papillomavirus (HPV) and cervical cancer prevention. The storyline centered on Lupita, a young woman recently diagnosed with HPV who informs her family about HPV and the availability of the HPV vaccine for her younger sister. The objective was to examine the roles of identification with characters and narrative involvement (made up of three dimensions: involvement, perceived relevance, and immersion) on perceived response efficacy, perceived severity, and perceived susceptibility to HPV and behavior (discussing the HPV vaccine with a health care provider). A random sample of 450 European American, Mexican American, and African American women between the ages of 25 and 45 years, living in the Los Angeles area, was surveyed by phone before, 2 weeks after, and 6 months after viewing the film. The more relevant women found the narrative to their own lives at 2 weeks, the higher they perceived the severity of the virus and the perceived response efficacy of the vaccine to be. Also at 2 weeks, identifying with characters was positively associated with perceived susceptibility to HPV but negatively associated with perceived severity. At 6 months, identification with specific characters was significantly associated with perceived threat and behavior. These findings suggest that different aspects of narrative health messages should be manipulated depending on the specific beliefs and behaviors being targeted. Implications for narrative message design are discussed.

Research Methods for Studying Evolutionary and Ecological Processes in Organizational Communication

In a previous MCQ article, Monge et al. overviewed the fundamental concepts and processes of evolutionary theory and their applications to key issues in organizational communication. This article extends that work by providing an overview of research tools for studying organizational ecology and evolution, including (a) the variation-selection-retention sequence, (b) the likelihood of events occurring over a period of time (event history analysis), (c) transition sequence of populations from one state to another (sequence analysis), (d) relationships among nodes in networks over time (network analysis), (e) simulation of complex relationships and interactions (computational modeling), (f) changes in populations’ fitness for survival (NKC models), and (g) competitive interdependence among populations over time (predator—prey models). We conclude with a brief review of graphical and qualitative methods.

An Argument for Ecological Research and Intervention in Health Communication

An Argument for Ecological Research and Intervention in Health Communication Meghan Bridgid Moran, Lauren B. Frank, Nan Zhao, Carmen Gonzalez, Prawit Thainiyom, Sheila T. Murphy & Sandra J. Ball-Rokeach To cite this article: Meghan Bridgid Moran, Lauren B. Frank, Nan Zhao, Carmen Gonzalez, Prawit Thainiyom, Sheila T. Murphy & Sandra J. Ball-Rokeach (2016) An Argument for Ecological Research and Intervention in Health Communication, Journal of Health Communication, 21:2, 135-138 To link to this article: http://dx.doi.org/10.1080/10810730.2015.1128021

Information Scanning and Vaccine Safety Concerns among African American, Mexican American, and Non-Hispanic White Women

OBJECTIVE A significant number of parents delay or refuse vaccinating their children. Incidental exposure to vaccine information (i.e., scanned information) may be an important contributor to anti-vaccine sentiment. This study examines the association between scanned information, trust in health information sources and vaccine safety concerns among African American, Mexican American, and non-Hispanic White women. METHODS Women (N=761) in Los Angeles County were sampled via random digit dial and surveyed regarding use of and trust in health information resources and vaccine safety concerns. RESULTS Analyses indicate that the sources of information associated with vaccine safety concerns varied by ethnicity. Each ethnic group exhibited different patterns of association between trust in health information resources and vaccine safety concerns. CONCLUSIONS Information scanning is associated with beliefs about vaccine safety, which may lead parents to refuse or delay vaccinating their children. These relationships vary by ethnicity. PRACTICE IMPLICATIONS These findings help inform practitioners and policy makers about communication factors that influence vaccine safety concerns. Knowing these sources of information will equip practitioners to better identify women who may have been exposed to anti-vaccine messages and counter these beliefs with effective, vaccine-promoting messages via the most relevant information sources.