Skip to main content

Advertisement

SpringerLink
Log in

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

  • Published:
Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract

Introduction

Cancer 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.

Methods

By 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.

Results

Participant 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.

Conclusions

The 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 survivors

Survivor 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Coreil J, Behal R. Man to man prostate cancer support groups. Cancer Pract. 1999;7(3):122–9.

    Article  PubMed  CAS  Google Scholar 

  2. Erwin D, Spatz T, Stotts R, Hollenberg J, Deloney L. Increasing mammography and breast self-examination in African American women using the witness project model. J Cancer Educ. 1996;11(4):210–5.

    PubMed  CAS  Google Scholar 

  3. Rogers TF, Bauman LJ, Metzger L. An assessment of the Reach to Recovery program. CA: A Cancer Journal for Clinicians. 1985;35(2):116–24.

    CAS  Google Scholar 

  4. Eysenbach G. The impact of the Internet on cancer outcomes. CA: A Cancer Journal for Clinicians. 2003;53:356–71.

    Google Scholar 

  5. Ghafoor A, Jemal A, Ward E, Cokkinides V, Smith R, Thun M. Trends in breast cancer by race and ethnicity. CA: A Cancer Journal for Clinicians. 2003;53:342–55.

    Article  Google Scholar 

  6. Kaur JS. The potential impact of cancer survivors on Native American cancer prevention and treatment. Cancer. 1996;78(7):1578–81.

    PubMed  CAS  Google Scholar 

  7. Lythcott N, Green BL, Brown ZK. The perspective of African American breast cancer survivor advocates. Cancer. 2002;97(S1):324–8.

    Article  Google Scholar 

  8. Schwartz C, Meisenhelder JB, Ma Y, Reed G. Altruistic social interest behaviors are associated with better mental health. Psychosom Med. 2003;65:778–85.

    Article  PubMed  Google Scholar 

  9. Thoits PA, Hewlett LN. Volunteer work and well-being. J Health Soc Behav. 2001;42:115–41.

    Article  PubMed  CAS  Google Scholar 

  10. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.

    Google Scholar 

  11. Kreuter MW, Green MC, Cappella JN, Slater MD, Wise ME, Storey D, et al. Narrative communication in cancer prevention and control: a framework to guide research and application. Annals Behav Med. 2007;33(3):221–35.

    Google Scholar 

  12. Thompson HS, Littles M, Jacob S, Coker C. Posttreatment breast cancer surveillance and follow-up care experiences of breast cancer survivors of African descent: an exploratory qualitative study. Cancer Nurs. 2006;29(6):478–87.

    Article  PubMed  Google Scholar 

  13. Bruner J. Actual minds, possible words. Massachusetts: Harvard University Press; 1986.

    Google Scholar 

  14. Hatcher J. The art and craft of playwriting. Cincinnati, OH: Storey; 1996.

    Google Scholar 

  15. Hicks ND. Screenwriting 101: The essence and craft of feature film writing. New York, NY: McNaughton and Guner; 1999.

    Google Scholar 

  16. Cacioppo JT, Petty RE. Effects of message repetition and position on cognitive responses, recall and persuasion. J Pers Soc Psychol. 1979;37:97–109.

    Article  Google Scholar 

  17. O’Keefe DJ. Standpoint explicitness and persuasive effect: a meta-analytic review of the effects of varying conclusion articulation in persuasive messages. Argum Advocacy. 1997;34:1–12.

    Google Scholar 

  18. Bandura A. Social cognitive theory in cultural context. J Appl Psychol, An International Review. 2002;51:269–90.

    Article  Google Scholar 

  19. Janz NK, Champion VL, Strecher VJ. The health belief model. In: Glanz K, Lewis F, Rimer B, editors. Health behavior and health education. 3rd ed. San Francisco: Jossey-Bass; 2002. pp. 45–66.

    Google Scholar 

  20. Lutrell W. Working-class women’s ways of knowing: effects of gender, race, and class. Sociol Educ. 1989;62:33–6.

    Article  Google Scholar 

  21. Abrums M. “Jesus will fix it after awhile”: meanings and health. Soc Sci Med. 2000;50:89–105.

    Article  PubMed  CAS  Google Scholar 

  22. Banks-Wallace J. Womanist ways of knowing: theoretical considerations for research with African American women. Adv Nurs Sci. 2000;22(3):33–5.

    CAS  Google Scholar 

  23. Collins P. (Ed.) (2000). Black feminist thought. 2nd ed. New York: Routledge.

  24. Miller RS, Perlman D, Brehm SS. Intimate relationships. Boston: McGraw-Hill; 2007.

    Google Scholar 

  25. Cialdini RB, Sagarin BJ. Principles of interpersonal influence. In: Brock TC, Green MC, editors. Persuasion: psychological insights and perspectives. 2nd ed. Newbury Park, CA: Sage; 2005. pp. 143–69.

    Google Scholar 

  26. Hass RG. Effects of source characteristics on cognitive responses and persuasion. In: Petty RE, Ostrom TM, Brock TC, editors. Cognitive responses in persuasion. Hillsdale, NJ: Lawrence Erlbaum Associates; 1981. pp. 141–72.

    Google Scholar 

  27. Petty RE, Cacioppo JT, Strathman AJ, Priester JR. To think or not to think: exploring two routes to persuasion. In: Brock TC, Green MC, editors. Persuasion: psychological insights and perspectives. 2nd ed. Needham Heights, MA: Allyn & Bacon; 2005. pp. 81–116.

    Google Scholar 

  28. Wengraf T. Qualitative research interviewing: biographic narrative and semi-structured methods. London: Sage; 2001.

    Google Scholar 

  29. Gubrium J, Holstein J. Narrative practice and the coherence of personal stories. Sociol Q. 1998;39(1):136–87.

    Article  Google Scholar 

  30. Eagly AH, Chaiken S. Attitude structure and function. In: Gilbert D, Fiske S, Lindzey G, editors. The handbook of social psychology. 4th ed. New York: McGraw-Hill; 1998. pp. 269–322.

    Google Scholar 

  31. Deshpande AD, Sanders-Thompson VL, Vaughn K, Kreuter MW (2007) Use of socio-cultural constructs in cancer research among African Americans: A review. Cancer Control (in press).

  32. Kreuter MW, Lukwago SN, Bucholtz D, Clark EM, Sanders-Thompson V. Achieving cultural appropriateness in health promotion programs: targeted and tailored approaches. Health Educ Behav. 2003;30(2):133–46.

    Article  PubMed  Google Scholar 

  33. Green MC. Transportation into narrative worlds: the role of prior knowledge and perceived realism. Discourse Process. 2004;38(2):247–66.

    Article  Google Scholar 

  34. Green MC, Brock T. The role of transportation in the persuasiveness of public narratives. J Pers Soc Psychol. 2000;79(5):701–21.

    Article  PubMed  CAS  Google Scholar 

  35. Cacioppo JT, Harkins SG. The nature of attitudes and cognitive responses and their relationship to behavior. In: Petty RE, Ostrom TM, Brock TC, editors. Cognitive responses in persuasion. Hillsdale, NJ: Lawrence Erlbaum Associates; 1981. pp. 31–4.

    Google Scholar 

  36. Petty RE, Wegner DT. Attitude change: Multiple roles for persuasion variables. In: Gilbert D, Fiske S, Lindzey G, editors. The handbook of social psychology. 4th ed. New York: McGraw-Hill; 1998. pp. 323–89.

    Google Scholar 

  37. Cohen J. Defining identification: a theoretical look at the identification of audiences with media characters. Mass Commun Soc. 2001;4(3):245–64.

    Article  Google Scholar 

  38. Singer JD, Willett JB. Applied longitudinal data analysis. Oxford: Oxford University Press; 2003.

    Google Scholar 

  39. Green MC. Narratives and cancer communication. J Commun. 2006;56:163S–83S.

    Article  Google Scholar 

  40. Hinyard L, Kreuter MW. Using narrative communication as a tool for health behavior change: a conceptual, theoretical, and empirical overview. Health Educ Behav. 2007;34(5):777–92.

    Article  PubMed  Google Scholar 

  41. Bailey E, Erwin D, Belin P. Using cultural beliefs and patterns to improve mammography utilization among African-American women: The Witness Project. J Natl Med Assoc. 2000;92(3):136–42.

    PubMed  CAS  Google Scholar 

  42. Bandura A. Self-efficacy: toward a unifying theory of behavior change. Psychol Rev. 1977;84(2):191–215.

    Article  PubMed  CAS  Google Scholar 

  43. Anderson RB, McMillion PY. Effects of similar and diversified modeling on African American women’s efficacy expectations and intentions to perform breast self-examination. Health Commun. 1995;7:327–43.

    Article  Google Scholar 

  44. Antman K, Abraido-Lanza AF, Blum D, Brownfield E, Cicatelli B, Debor MD, et al. Reducing disparities in breast cancer survival: a Columbia University and Avon Breast Cancer Research and Care Network symposium. Breast Cancer Res Treat. 2002;75:269–80.

    Article  PubMed  Google Scholar 

  45. Kreuter MW, Strecher VJ, Glassman B. One size does not fit all: the case for tailoring print materials. Annals Behav Med. 1999;21(4):276–83.

    CAS  Google Scholar 

Download references

Acknowledgement

This study was supported by a grant from the National Cancer Institute’s Centers of Excellence in Cancer Communication Research program (CA-P50-95815). The authors thank JoAnne Banks Wallace and Shanti Parikh for assistance with formative research, Jean Freeman, Hollie Milam and Kim Vaughn for assistance capturing survivor stories, Dana Weston, Maria Hamtil-Hockenhull, Delores Dotson, Keri Jupka, Catina Scott, Kim Kennedy and Leslie Hinyard for indexing and coding survivor stories, Christine Dao and Kia Davis for administering the research protocol, and Sharon Homan, Qiang Fu, Melanie Green and Mike Slater for helping with research design and analytic methods. We are especially grateful to the 49 breast cancer survivors and family members who shared their stories, without whom this research would not be possible. The Murchison Tabernacle Cancer Support Group, Sistah Connection, The Breakfast Club, Inc., The Witness Project and Mustard Seed were key partners in identifying breast cancer survivors.

Author information

Authors and Affiliations

  1. Health Communication Research Laboratory and Center for Cultural Cancer Communication, School of Public Health, Saint Louis University, 3545 Lafayette Avenue, St. Louis, MO, 63104, USA

    Matthew W. Kreuter, Kathleen Holmes, Lou Robinson, Xuemei Si, Suchita Rath & Anne Philipneri

  2. Department of Community Health, Saint Louis University, St. Louis, MO, USA

    Trent D. Buskirk

  3. Department of Psychology, Saint Louis University, St. Louis, MO, USA

    Eddie M. Clark

  4. Roswell Park Cancer Institute, Buffalo, NY, USA

    Deborah Erwin

  5. Department of Communication, University of Kentucky, Lexington, KY, USA

    Elisia Cohen

  6. ConnectCare, St. Louis, MO, USA

    Katherine Mathews

Authors
  1. Matthew W. Kreuter
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Trent D. Buskirk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kathleen Holmes
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eddie M. Clark
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lou Robinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Xuemei Si
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Suchita Rath
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Deborah Erwin
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Anne Philipneri
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Elisia Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Katherine Mathews
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Matthew W. Kreuter.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kreuter, M.W., Buskirk, T.D., Holmes, K. et al. What makes cancer survivor stories work? An empirical study among African American women. J Cancer Surviv 2, 33–44 (2008). https://doi.org/10.1007/s11764-007-0041-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11764-007-0041-y

Keywords

Search

Navigation