Equal Cancer Care - African American
Minority Patients Prefer Empowering Cancer Messages
Thursday, October 30 2008 00:00
Harping on negative consequences of a lack of cancer screening among minorities can actually make African-Americans less likely to go for screening, according to behavioral science research published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.
"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," said Robert Nicholson, Ph.D., an assistant professor in the Department of Neurology and Psychiatry at the St. Louis University School of Public Health. "Instead of motivating people who would be less likely to get these services in the first place, we may be driving them away."
Historically, minority communities have been deprived of a fair share of benefits from cutting-edge medical efforts. Sensitive to this history, cancer advocacy groups have tried to reach out to minority communities to raise levels of access to known prevention and treatment strategies. But no one knew whether the message was getting across in an effective way.
Nicholson and colleagues conducted a double-blind, randomized trial among 300 African-American adults. The adults were asked to read one of four articles about colon cancer and then answer questions about their likelihood of getting screened.
- The first article emphasized that colon cancer was an important problem for African-Americans.
- The second emphasized that outcomes for blacks with colon cancer were worse than for whites.
- A third approached said that although outcomes for African-Americans were improving the improvement was less than seen among whites.
- Finally, a fourth article discussed how outcomes for blacks with colon cancer were improving over time.
If African-Americans read the article that said outcomes for blacks were improving over time, they were more likely to have a positive emotional response than if they read any of the other three articles. The article most likely to cause a negative response was the one that simply stated the problem.
Those who read the article about African-Americans making progress in outcomes for colon cancer were far more likely to want to be screened than those who read any of the other three articles.
The mean age of the participants was 54.4 years, 76 percent were women and 89 percent had completed high school. Comprehension analysis found that all participants understood what they had read.
Nicholson said his team did not ask questions about motivation, but he believes that a general mistrust of the medical community may be playing a role. If information reinforces that mistrust, then African-Americans are less likely to be screened.
"We believe that a positive message would go a long way toward overcoming mistrust," Nicholson said. "We need the right kind of message for the right kind of person, and not to assume that what we have always done is working."
The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world’s oldest and largest professional organization dedicated to advancing cancer research. The AACR also publishes CR, a magazine for cancer survivors and their families, patient advocates, physicians and scientists. CR provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship and advocacy.
