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

Murphy, Sheila T.; Frank, Lauren B.; Chatterjee, Joyee S.; Moran, Meghan Bridgid; Zhao, Nan; Herrera, Paula Amezola de; Baezconde‐Garbanati, Lourdes

doi:10.2105/ajph.2014.302332

Cited by 105 publications

(104 citation statements)

References 37 publications

(31 reference statements)

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“…In recent decades, methodological pluralism is evident, 50 including more studies that employ experimental design to assess the effect of various narrative persuasion mechanisms. 37,51 Telephone hotlines have tracked viewer response post-exposure to an edutainment program. 52 Participant observation and in-depth interviews have provided deeper insights into the viewer's experience.…”

Section: Methodsmentioning

confidence: 99%

“…[32][33][34] Moreover, empirical studies show supporting evidence of narrative-based interventions for racial/ethnic minority groups to reduce disparities. [35][36][37] Narrative persuasion theories guided the ELH program development (in terms of character building and content production) and its program evaluation (in terms of choosing key measures and hypotheses).…”

Section: 31mentioning

confidence: 99%

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East Los High: Transmedia Edutainment to Promote the Sexual and Reproductive Health of Young Latina/o Americans

Wang

Singhal

2016

Am J Public Health

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1,2 By 2020, as per Census projections, 25% of American teens will be Latina/o. 3These changing demographics hold significant implications for public health. Although risky sexual behaviors among American youth have declined since 1990, Latina/o youth have higher rates of sexually transmitted infections (STIs) and unintended pregnancies than other racial/ethnic groups. [4][5][6] One in 3 Latina teens become pregnant before the age of 20, 1.5 times the national average. 3 This is not surprising as only about half of sexually active Latina/o teens reported using a condom during their last intercourse, and only 1 in 7 used birth control pills or other contraceptives. 7 Latina teen mothers bear the greatest burden of higher order and rapid repeat pregnancies. Edutainment programs are also grounded in social cognitive theory, an agentic framework of psychosocial change with a dual path of influence: direct exposure to media models and indirect social learning through interpersonal discussions. 27 The transportation-imagery model posits that narratives can be highly immersive, prompting 6 the audience to pay attention, generate mental imagery of a prospective potentiality, and transport them into a world of different time and space. 28 In addition, narratives resonate particularly well with the audience when they perceive the stories to be realistic and can identify with the characters based on existing similarities or desirable attributes. 26,29,30 Further, theories of culture-centric health promotion emphasize that narratives built with familiar cultural markers are especially effective when targeting minority populations. 12,31Recent meta-analyses have demonstrated the advantages of using narratives in health interventions: Narratives have a sizable significant impact on combined changes in attitudes, intention, and behavior, even if they have a relatively small effect size in individual outcomes. Narratives are powerful interventional tools for eliciting affective audience response; and evidence suggests that those delivered through audio and video are more effective than print. [32][33][34] Moreover, empirical studies show supporting evidence of narrative-based interventions for racial/ethnic minority groups to reduce disparities. 35-37Narrative persuasion theories guided the ELH program development (in terms of character building and content production) and its program evaluation (in terms of choosing key measures and hypotheses). ELH PROGRAM DEVELOPMENTAt least 3 unique aspects of ELH set it apart from popular series such as Degrassi completed the study. They were randomly assigned to 1 of the following conditions. Condition 1 (n=30) was a true control group without any intervention. Condition 2 (n=21) was a non-dramatic text version of ELH presented as a newspaper story.Condition 3 (n=21) was a dramatic text version, presented as an ELH script. Condition 4 (n=32) was an online drama, presented as an abbreviated version of ELH Hulu series.Condition 5 (n=32) was a transmedia version, presented as the online dra...

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Section: Methodsmentioning

confidence: 99%

Section: 31mentioning

confidence: 99%

East Los High: Transmedia Edutainment to Promote the Sexual and Reproductive Health of Young Latina/o Americans

Wang

Singhal

2016

Am J Public Health

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“…41, 42 Although the primary aim of this larger study did not involve comparing the efficacy of the films in women with varying levels of health literacy, we included a measure of health literacy so that we could conduct post-hoc analyses to examine the relative effects. All study procedures were approved by the researchers’ university Institutional Review Board.…”

Section: Methodsmentioning

confidence: 99%

A pilot test of the acceptability and efficacy of narrative and non-narrative health education materials in a low health literacy population

Moran

Frank

Chatterjee

et al. 2016

Journal of Communication in Healthcare

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Although entertainment-education narratives are increasingly being used to communicate health information to a diversity of populations, there is limited evidence examining the use of narrative health education videos in low compared with adequate health literacy populations. There are also very few studies directly comparing narrative materials to more traditional, non-narrative materials. Because individuals with low health literacy are less likely than those with adequate health literacy to benefit from health communication interventions, it is especially important to develop an evidence base supporting the use of narrative health education materials in low literacy populations. This study extends knowledge on the use of narrative health education materials in populations with low health literacy by conducting a randomized trial comparing the acceptability and efficacy (knowledge gain) of two fact-equivalent films, one in a narrative and one in a non-narrative format, on individuals with adequate and low health literacy. This study finds that while both films were well-accepted and produced knowledge gains, the narrative film was more effective in this regard. This effect occurred regardless of health literacy level, indicating that narrative health communication materials are appropriate for individuals with low health literacy and do not exacerbate existing health disparities. These findings add to a small but growing body of evidence testing narrative health education materials in individuals with low health literacy, and provide new evidence supporting narrative, entertainment-education style video as a health communication tool to help reduce health literacy-related health disparities.

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“…Social support is important for behavior change broadly, 13–15 and ample evidence indicates that existing social media groups can provide informational and emotional support to cancer survivors and caregivers. 16–18 Online communities have been linked to increased empowerment 19 and retention 20 ; engagement with the communities has been linked to behavior change success for weight loss, smoking cessation, and other cancer-related behaviors, 8,21,22 although some effects are small. 23–25 Additionally, structured short message service and text messages to generate forum discussions, provide reminders, or offer tips and strategies have been effective build-ins.…”

Section: Key Principles Of Social Media To Enhance Cancer Prevention mentioning

confidence: 99%

“…Both large-scale national and international campaigns as well as smaller campaigns by local organizations and clinics have demonstrated engagement with their target audiences using social media. 14,15 Role model narratives are effective methods of persuasion with demonstrated positive impacts on cancer prevention behaviors 19–21 and can easily be delivered using video and photo tools in most popular social media systems. Evaluation of a breast cancer awareness campaign launched on Facebook by the Centers for Disease Control and Prevention found greatest engagement for posts with photos rather than status/links or videos; posts released in the early morning and afternoon (2:00 PM to 6:00 PM) versus other time periods; and posts shared earlier (2014) than later (2016) in the campaign.…”

Section: Key Principles Of Social Media To Enhance Cancer Prevention mentioning

confidence: 99%

Social Media and Mobile Technology for Cancer Prevention and Treatment

Prochaska

Coughlin

Lyons

2017

American Society of Clinical Oncology Educational Book

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OVERVIEW Given the number of lives affected by cancer and the great potential for optimizing well-being via lifestyle changes, patients, providers, health care systems, advocacy groups, and entrepreneurs are looking to digital solutions to enhance patient care and broaden prevention efforts. Thousands of health-oriented mobile websites and apps have been developed, with a majority focused upon lifestyle behaviors (e.g., exercise, diet, smoking). In this review, we consider the use and potential of social media and mHealth technologies for cancer prevention, cancer treatment, and survivorship. We identify key principles in research and practice, summarize prior reviews, and highlight notable case studies and patient resources. Further, with the potential for scaled delivery and broad reach, we consider application of social media and mHealth technologies in low-resource settings. With clear advantages for reach, social media and mHealth technologies offer the ability to scale and engage entire populations at low cost, develop supportive social networks, connect patients and providers, encourage adherence with cancer care, and collect vast quantities of data for advancing cancer research. Development efforts have been rapid and numerous, yet evaluation of intervention effects on behavior change and health outcomes are sorely needed, and regulation around data security issues is notably lacking. Attention to broader audiences is also needed, with targeted development for culturally diverse groups and non-English speakers. Further investment in research to build the evidence base and identify best practices will help delineate and actualize the potential of social media and mHealth technologies for cancer prevention and treatment.

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

Abstract: Narratives might prove to be a useful tool for reducing health disparities.

Cited by 105 publications

References 37 publications

East Los High: Transmedia Edutainment to Promote the Sexual and Reproductive Health of Young Latina/o Americans

East Los High: Transmedia Edutainment to Promote the Sexual and Reproductive Health of Young Latina/o Americans

A pilot test of the acceptability and efficacy of narrative and non-narrative health education materials in a low health literacy population

Social Media and Mobile Technology for Cancer Prevention and Treatment

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