Culturally Appropriate Breast Cancer and Environmental Risk Messages: Targeting Racially and Ethnically Diverse Mothers

Breast cancer is the most common cancer among women in the United States. It’s also the leading cause of death for women globally. But educational information that doesn’t take into account cultural differences among women may not be as effective as communication embracing those differences.

University of Florida College of Journalism and Communications Associate Professor and UF Health Cancer Center Member Dr. Carla L. Fisher and a team of researchers at George Mason University received funding from the National Institutes of Environmental Health Sciences (NIEHS) and National Cancer Institute (NCI) to identify ways to tailor breast cancer risk messages to mothers and daughters.  They worked with “mommy bloggers” to disseminate an evidence-informed infographic about lifestyle changes mothers and daughters can do together to reduce the environmental risk of breast cancer.

By partnering with “mommy bloggers,” they created a social media intervention where bloggers integrated the infographic into their blogs about breast cancer risk. The intervention successfully altered mothers’ perspectives on risk and intentions to adopt risk-reducing lifestyle behaviors.

Because breast cancer messages informed by culture are more likely to affect women’s behavior, these researchers also interviewed mothers — community members who participated in the intervention — to identify ways to make these messages more culturally appropriate.

They identified five cross-cultural message design strategies to ensure messages can appeal to women of different cultures and, ultimately, promote healthy behavior changes:

• Incorporate diverse images
• Provide more information specific to environmental and cultural risk
• Heighten the message of “it’s a family affair”
• Make behavioral changes feasible
• Use less text and more visuals

Mothers prioritized more sophisticated linguistic approaches, such as using less text and more visuals, including diverse images. Their perspectives as to why this approach was important also varied culturally. For instance, even though diverse images emerged across cultures, Black and Hispanic women wanted multiple races depicted in images to convey that mothers of all cultures are at risk for breast cancer.

Mothers also advocated for using sociocultural approaches, such as depicting risk as something that affects the entire family, to engage multiple generations in lifestyle changes, which was challenging with older family members. Older generations were less open about health issues as they were socialized to view health as private and taboo to discuss. They were also resistant to changing lifelong lifestyle behaviors. Mothers admitted to refraining from further interactions to protect their relational hierarchies when older generations were resistant, which could shut down risk-reducing lifestyle behavior changes as a family.

Mothers noted that messages designed to appeal to older generations, portraying risk as an intergenerational “family affair,” could better involve and persuade older kin to protect grandchildren. They believed this emotional appeal would promote grandparents’ acceptance of lifestyle changes because it would be less about what they did as parents and instead about what they can do to enhance grandchildren’s health, protecting their “legacy.”

Future scholarship can extend the study by testing the efficacy of these strategies when targeting various racial/ethnic groups of mothers as well as mothers broadly. A cross-cultural approach targeting Black and Hispanic women could also be developed and tested, given the shared cross-cultural factors observed in this study.

The original research paper, “Culturally Appropriate Breast Cancer and Environmental Risk Messages: Targeting Racially and Ethnically Diverse Mothers” appeared in the Journal of Cancer Education, Dec. 9, 2019.

 Authors: Carla L. Fisher, Ph.D., Kevin B. Wright, Ph.D., Camella J. Rising, Ph.D., Michaela Devyn Mullis, Ph.D., Dasha Afanseva, M.P.H., Amelia Burke-Garcia, Ph.D., Xiaomei Cai; Corresponding author: Carla L. Fisher, carlalfisher@ufl.edu.

This summary was written by Marie Morganelli, Ph.D.

Posted: July 29, 2020
Tagged as: breast cancer, Carla Fisher, Diversity