April 2-4, 2020 • Hyatt Regency • Lexington, KY
Intersectionality and Interdisciplinarity in Health Communication Research
Abstract: Health Communication Cancer Screening Messages for Black Women: Review and Recommendations for Future Research
◆ Diane B. Francis, University of Kentucky
◆ Adriane Grumbein, University of Kentucky
◆ Carina M. Zelaya, University of Kentucky
◆ Mariam Said, University of Kentucky
Health communication strategies have become essential to reducing cancer health disparities (Viswanath & Emmons, 2009). Despite the large and growing literature on health communication to increase cancer screening among African Americans (Adedoyin et al., 2016; Wolff et al., 2003), there have been no attempts to synthesize what is known about cancer screening messaging for Black women. To inform future cancer screening health communication interventions and campaigns, the current review aims to determine what message strategies have been developed and tested for Black women in the extant literature.
The study used systematic review design to gain a comprehensive understanding of what is known about cancer screening messaging for Black women. Six computerized databases were searched in June 2019 to locate relevant studies. The authors developed a list of search terms to encompass cancer, screening, interventions, campaigns, and messages. We kept the search broad to focus on messaging more generally instead of a specific message or cancer type. The initial search yield 7,121 references which were assessed through a systematic detailed strategy. Two coders independently coded all relevant studies on sample, study, and message characteristics.
The final sample consisted of 36 studies published within the past 20 years (1999-2019). Half of the studies focused on breast cancer (k = 20), and the remainder on colorectal (k = 16) or cervical (k = 1) cancer. Sample sizes ranged from 15 to 766 participants. Participants were 18 to 88 years old; however, most studies (k = 26) focused on women 40 and older. All studies used convenience samples. Women were recruited through churches or faith-based organizations (42%), community settings (39%), healthcare facilities (19%), the Internet (6%) and other venues. Most studies (72%) were randomized controlled trials testing interventions with health messaging components; seven studies reported specifically on the formative research process. The health belief model was used to guide several studies (28%), followed by social cognitive theory (14%) and the reasoned action approach (11%). Messages were primarily distributed through small media such as posters and billboards (36%), community-based activities (31%), and videos (28%).
The research indicates a limited range of message design approaches have been utilized. Spiritual/religious appeals (39%) were the primary message approach used with Black women. Other message approaches used ranged from tailoring (30%) and framing (8%) to narrative and/or testimonials (14%). Much of the cancer screening health communication research with Black women were focused on assessing the effectiveness communication channels (e.g., computer tailored vs. print interventions) rather than addressing the specific messages which would motivate women to screen for cancer. Furthermore, there appears to be a dearth of specificity on how cancer screening messages are constructed for Black women; the research to date has made limited use of message design theories to inform their health communication interventions.
Given the increasing incidence of some cancers among Black women, including younger Black women, more research is needed on effective messages to communicate the importance of cancer prevention and screening to those audiences at risk. Message design recommendations will be discussed.