Emotional Response to the Use of Narrative in Cancer Communication

Background. The importance of communicating breast cancer prevention and control messages to at-risk populations cannot be overstated. African American women are considered a vulnerable population in that, although their incidence rate for breast cancer is 10% lower than white women, they have a 37% higher death rate from the disease overall. This study sought to elucidate the effects of narrative approaches to breast cancer prevention messages by examining the impact of narrative on emotion and memory. The primary objectives were to: 1) Identify and compare real-time, moment-to-moment emotional responses to the Living Proof breast cancer survivors' stories video to the content-equivalent, non-narrative Facts for Life video; 2) Describe and characterize points of high emotional response to the videos; and 3) Examine the relationship between participants' emotional responses to each video and later recall of specific breast cancer messages. Methods. This study used moment-to-moment audience analysis methods to identify specific points of peaked emotional response to two breast cancer communication videos, one using survivors' stories told in narrative fashion and the other using a more traditional, didactic approach. Participants from a community-based convenience sample of 59 African American women used a hand-held dial (known as a Perception Analyzer®) to track intensity of perceived emotional response while watching one of the 22-minute videos. Participants were randomly assigned to watch either the narrative video, Living Proof, or the non-narrative video, Facts for Life. Use of the dial during viewing created a visual line graph of data, where each second of viewing was recorded longitudinally and displayed using accompanying Perception Analyzer® software. For each participant, the five highest points of peaked emotional response were identified and in-depth information about the emotions experienced during these peaks were elicited. Results. First, distinct differences emerged in the location of peaked emotional responses when comparing the two videos. For those who watched the narrative, Living Proof video, the non-message, interpersonal content elicited greater peaked emotional response as compared to those who watched the non-narrative, Facts for Life video. Secondly, the types of emotions experienced during peaked emotional response differed between the two groups. Those who watched Living Proof were significantly more likely to feel attentive, inspired, and proud, and were significantly less likely to feel upset as compared to those who watched the Facts for Life video (p<.05). Lastly, in open-ended interview questions, participants who watched Living Proof talked about the women and their personal stories significantly more than the health educational messages, and yet, were able to recall the central message of the video as frequently as those who watched the Facts for Life video. Conclusions and Implications. Through an innovative method of data collection, the research team was able to track intensity of perceived emotion in real time as participants watched breast cancer prevention and control videos. This method provided information about the most salient parts of the prevention messages. Although exploratory in nature, this insight is useful in informing prevention techniques as social work clinicians and researchers seek to communicate messages effectively to underserved populations.