Cancer Communications Research and Health Outcomes: Review and Challenge
Kreps, Gary L., Massimilla, Daria Chapelsky, Communication Studies
Cancer communications is the study and application of the use of strategically designed messages delivered through selected media, to convey relevant health information to targeted audiences (of health care consumers, cancer survivors, health care providers, researchers, patients, at-risk populations, and others) to promote cancer prevention and control, encourage cancer screening and early detection activities, reduce cancer morbidity and mortality, and enhance the quality of life (Kreps & Viswanath, 2001). This is a very exciting and potentially propitious new area of research and intervention. Consequently, a major investment in cancer communications research proposed by the National Cancer Institute is timely. Communications can raise awareness of health problems and recommended actions, and give people the information they need to make informed cancer-related decisions (e.g., AHRQ, 2000; Skinner, Campbell, Rimer, Curry, Prochaska, 1999; O'Connor et al., 1999; Science Panel on Interactive Communication and Health, 1999). Moreover, effective communications can influence people to engage in behaviors that will improve their health, such as stopping smoking or undergoing screening for certain types of cancer. Although use of media alone can produce behavioral change, the effect is increased when its use is supplemented by other community-based educational efforts (Farquhar et al., 1977; Puska et al., 1985; Flay, 1987). The theoretical basis of this effect is that increased knowledge and understanding alone do not motivate a person to change. Other factors, such as self-efficacy, skills to implement the change, convenience, and social and cultural mores all influence the decision to change (Maibach & Cotton, 1995).
A large body of health communication literature has demonstrated the powerful influences of communication interventions on a broad range of health behaviors and health outcomes. For example, Kreps and O'Hair (1995) report a series of studies showing the influences of intrapersonal, interpersonal, group, organizational, and societal communications on health knowledge, behaviors, and outcomes. Similarly, Greenfield, Kaplan, and Ware (1985) demonstrate the positive influences of increased patient communicative involvement in treatment on desired health outcomes. Dearing et al. (1996) illustrate the positive influences of social marketing and diffusion-based strategies in encouraging at-risk populations to adopt important prevention behaviors. Large-scale longitudinal communication intervention programs, such as the Stanford Five City Heart Health Program and the Minnesota Heart Health communication program demonstrate the influences of these campaigns on promoting adoption of lifestyle changes to prevent cardiovascular disease and reducing gaps in public health knowledge (Flora, Maccoby, & Farquhar, 1989; Pavlik et al., 1993). This report provides a focused review of current research evidence linking health communication interventions to important cancer control and prevention outcomes.
This report presents a review of the published research literature on cancer communications. We conducted MEDLINE, ERIC, and COMINDEX searches of the literature in early 2000 and identified 52 relevant and current (within the last decade) articles that provide strong outcome data (data concerning relevant behavioral, psychological, or physiological health outcomes) on the effectiveness of strategic communications in cancer control (see Kreps & O'Hair, 1995). Recent publications were selected for this review as they encompass the state-of-the-art communication strategies in cancer communications, including the more tailored approaches towards changing health behaviors. The studies or reviews cited were selected on the basis of showing outcome data on the effectiveness of communications strategies in promoting healthy behaviors, particularly those associated with the reduction of cancer risk. …