Unintended effects of emphasizing disparities in cancer communication to African-Americans

Robert A Nicholson, Matthew W Kreuter, Christina Lapka, Rachel Wellborn, Eddie M Clark, Vetta Sanders-Thompson, Heather M Jacobsen, Chris Casey, Robert A Nicholson, Matthew W Kreuter, Christina Lapka, Rachel Wellborn, Eddie M Clark, Vetta Sanders-Thompson, Heather M Jacobsen, Chris Casey

Abstract

Little is known about how minority groups react to public information that highlights racial disparities in cancer. This double-blind randomized study compared emotional and behavioral reactions to four versions of the same colon cancer (CRC) information presented in mock news articles to a community sample of African-American adults (n = 300). Participants read one of four articles that varied in their framing and interpretation of race-specific CRC mortality data, emphasizing impact (CRC is an important problem for African-Americans), two dimensions of disparity (Blacks are doing worse than Whites and Blacks are improving, but less than Whites), or progress (Blacks are improving over time). Participants exposed to disparity articles reported more negative emotional reactions to the information and were less likely to want to be screened for CRC than those in other groups (both P < 0.001). In contrast, progress articles elicited more positive emotional reactions and participants were more likely to want to be screened. Moreover, negative emotional reaction seemed to mediate the influence of message type on individuals wanting to be screened for CRC. 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.

Conflict of interest statement

Disclosure of Potential Conflicts of Interest

No potential conflicts of interest were disclosed.

Figures

Figure 1
Figure 1
Positive and negative affective response to reading news article by type of news article read.
Figure 2
Figure 2
Behavioral desire (wanting) to be screened, by medical mistrust.
Figure 3
Figure 3
Negative affective response mediates the relationship between type of news article read and wanting to be screened for CRC.

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