If You Want Change, Tell a Culturally Relevant Story — Not Just Facts

Latin American women in Los Angeles County are twice as likely as white women to contract cervical cancer, according to the Los Angeles County Department of Public Health, and are significantly less likely to understand the causes of the disease or to be screened for it.

That needs to change, say USC researchers, who are finding ways to make it happen.

“Latinas are the ones most at risk and yet health communication campaigns still essentially target white women,” said Sheila Murphy, professor at the USC Annenberg School for Communication and Journalism.

Murphy teamed up with colleagues from the Keck School of Medicine of USC and the USC School of Cinematic Arts to find a better way to communicate public health messages.

Tracking a group of more than 900 randomly selected women from Los Angeles that included Mexican-American, African-American and white women, the researchers demonstrated that a narrative video encouraging women to get screened for cervical cancer and featuring Mexican-American characters helped that group go from the least-screened to the most-screened within six months.

“It’s not just the narrative — it’s the cultural themes and the ethnicities of the people on screen. Telling a story stripped of those elements is, by default in the United States, just telling a ‘mainstream’ story. If you want to reach Mexican-American women, you have to tell a compelling, culturally relevant story,” said Lourdes Baezconde-Garbanati of the Keck School of Medicine, co-author of the study.

Their findings were published by American Journal of Public Health on April 23.

Women from each ethnicity in the study were shown one of two videos about the cause of cervical cancer and how to detect it via Pap tests. One of the videos — The Tamale Lesson — featured a narrative story about a Mexican-American family’s preparation for a daughter’s quinceañera. The other — It’s Time — presented the same facts but with doctors and patients explaining them.

“Both the narrative and non-narrative films were produced by the same team and were high-quality videos that did a good job of explaining the reasons to have a Pap test. The only difference is the way the information is presented,” Murphy said.

The videos were crafted by Doe Mayer and Jeremy Kagan at the cinematic arts school’s Change Making Media Lab.

Before watching the videos, only about 32 percent of the Mexican-American women surveyed were in compliance with recommended cervical cancer screening guidelines. Comparatively, roughly half of African-American and white women had a Pap test in the past two years.

Six months later, 83 percent of Mexican-American women who watched The Tamale Lesson were in compliance, compared to 73 percent of Mexican-American women who watched It’s Time.

The narrative story produced a similar, though less-pronounced, effect on African-American women — holding about a 6 percentage-point edge over the non-narrative story. Among white women, the narrative and non-narrative films were equally effective in prompting women to be screened.

The researchers said they hope the study and future research along these lines will help inform the way public health officials craft health messages.

“Public health officials need to realize what advertisers have known for decades. You can’t just present facts and hope people will change their behavior. If you want your audience to engage, you have to tell them a story that they care about,” Murphy said.

The research was supported by the National Cancer Institute at the National Institutes of Health (grants R01CA144052 and P30CA014089).