Negative Media Messages Discourage CRC Screening in Blacks

When African Americans hear a positive message that emphasizes progress being made for blacks with colon cancer, they are much more likely to want to be screened.  On the other hand, negative messages that talk about their poorer outcomes make them less willing to have screening tests.

Health communications researchers at St. Louis University asked 300 African-Americans to read one of four mock news articles about colorectal cancer, chosen randomly.  Three messages were negative, emphasizing differences from whites. One focused on the progress that blacks were making surviving colorectal cancer.

Participants who read the positive article had more positive emotional reactions and more often said they wanted to be screened.  The negative articles had the opposite effect.

Messages in the fake news articles included:

  • Colorectal cancer is an important problem for African-Americans.
  • Outcomes for blacks with colon cancer are worse than those for whites.
  • Although outcomes for blacks are improving, they are not improving as fast as white outcomes.
  • Outcomes for blacks are improving over time.

The first three messages elicited negative emotions and an unwillingness to be screened.  The fourth led to more positive emotional responses and desire for screening.  The most negative emotions came from the first message that simply said that colorectal cancer was an important problem for African-Americans.

Robert A. Nicholson, Ph.D. said that media messages in minority communities may not be doing what we expect them to. He said,

We have typically assumed that one of the best ways to motivate individuals is to point out disparities in health, but we may be having negative unintended consequences. Instead of motivating people who would be less likely to get these services in the first place, we may be driving them away.

Participants in the study were mostly women (76 out of 100) and had at least a high school education (89 out of 100.)  Their average age was 54.

Nicholson and his colleagues concluded,

Overall, these results suggest that the way in which disparity research is reported in the medium can influence public attitudes and intentions, with reports about progress yielding a more positive effect on intention. This seems especially important among those with high levels of medical mistrust who are least likely to use the health care system and are thus the primary target of health promotion advertising.

SOURCE: Nicholson et al., Cancer Epidemiology, Biomarkers, and Prevention, Volume 17, Issue 11, November 1, 2008.

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