142nd APHA Annual Meeting and Exposition

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Does spiritual-framing increase the effectiveness of breast cancer screening messages for African American women?

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 3:30 PM - 3:50 PM

Alicia Best, PhD, MPH, CHES , Department of Research and Community Health, HEALing Community Center, Atlanta, GA
Mindi Spencer, PhD, MA , Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
Daniela B. Friedman, MSc, PhD , Arnold School of Public Health, University of South Carolina, Columbia, SC
Ingrid Hall, PhD, MPH , Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
Deborah L. Billings, PhD , Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
Background

Spiritual-framing of health promotion messages may provide a useful strategy to address disparate breast cancer mortality rates among African American (AA) women. The goal of this study was to test the effectiveness of a spiritually-framed breast cancer screening (BCS) message versus a traditional BCS message among a sample of AA women.

Methods

We conducted an RCT in which 200 AA women reviewed a spiritually-framed or traditional BCS message and completed a self-administered survey. Key outcomes included number of thoughts generated (elaboration), ratio of positive to negative thoughts (polarity), and intention to obtain/recommend a mammogram (post-intention).

Results

We used a series of three multiple linear regression models to predict elaboration, polarity, and post-intention, while controlling for demographics, religiosity, spirituality, general concern with breast cancer, and pre-intention. Results indicated that spiritual-framing was positively associated with greater elaboration in Model 1 (R2=.08; β =.27, SE=.36, p<.001) and a greater proportion of positive thoughts in Model 2 (R2=.16; β =.24, SE=.04, p<.001). In Model 3, spiritual-framing was not associated with post-intention (R2=.34; β =.08, SE=.52. p=.16). Subsequent mediation analysis revealed that polarity mediated the relationship between spiritual-framing and post-intention.

Conclusion

This study provided evidence that spiritual-framing may improve the effectiveness of BCS messages among AA women by promoting positive reflection. Further, spiritual-framing had an indirect effect on participants’ intentions to obtain/recommend a mammogram through the generation of more positive thoughts. Interventions targeting AA women should consider the role of spirituality when tailoring BCS messages to ultimately reduce breast cancer disparities.

Learning Areas:

Chronic disease management and prevention
Communication and informatics
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Social and behavioral sciences

Learning Objectives:
Describe the importance of integrating spirituality into breast cancer screening (BCS) messages to address breast cancer disparities among African American (AA) women. Identify a method for assessing the effectiveness of spiritually-framed BCS messages compared to traditional BCS messages. Describe the association between spiritual framing and intention to obtain or recommend a mammogram among AA women.

Keyword(s): Cancer Prevention and Screening, Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator or co-investigator of multiple federally and non-federally funded research studies focusing cancer-related health disparities, health communication, and the interface between faith and health. My research to date has focused broadly on understanding the mechanisms through which behavioral, psychosocial, and cultural (e.g. spirituality) factors impact cancer-related health disparities among African Americans.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.