COTCCOTCAppropriate Messages about Appropriate Messages about

Diet Relating to Breast Cancer Diet Relating to Breast Cancer

►Charles AtkinCharles Atkin PhDPhD MSU Communication MSU Communication

►Maria LapinskiMaria Lapinski PhDPhD MSU Com/Food MSU Com/Food Safety Safety

Diet Communication Diet Communication StrategiesStrategies

►TARGET AUDIENCESTARGET AUDIENCES

►TARGET BEHAVIORSTARGET BEHAVIORS

►COMMUNICATION CHANNELS COMMUNICATION CHANNELS

►CAMPAIGN SOURCESCAMPAIGN SOURCES

►PERSUASIVE APPEALSPERSUASIVE APPEALS

►CULTURAL APPROPRIATENESSCULTURAL APPROPRIATENESS

Target AudiencesTarget AudiencesDirect vs. Indirect Message FlowDirect vs. Indirect Message Flow

► Message Message GirlsGirls

► Message Message MothersMothers GirlsGirls

► Message Message PolicymakersPolicymakers GirlsGirls

Which Target Responses?Which Target Responses?

SOCIAL MARKETING: “Product Line”… e.g.SOCIAL MARKETING: “Product Line”… e.g.

-- Eat specific healthy foods-- Eat specific healthy foods

-- Avoid specific junk/risky foods-- Avoid specific junk/risky foods

-- Consume fewer total calories-- Consume fewer total calories

-- Serve children nutritious diet-- Serve children nutritious diet

-- Pressure fast food chain to offer -- Pressure fast food chain to offer

optionsoptions

Representation of Target Representation of Target BehaviorBehavior

1. VISUAL modeling1. VISUAL modeling (suitable for (suitable for

imitation)imitation)

2. VERBAL 2. VERBAL

recommendation/exhortationrecommendation/exhortation

3. IMPLICIT suggestion3. IMPLICIT suggestion

Type of messageType of message

1. 1. INSTRUCTIONINSTRUCTION HowHow

2. 2. PERSUASIONPERSUASION WhyWhy

3. 3. AWARENESSAWARENESS What What WhenWhen

Why instructional?Why instructional?

►Learn which foods to chooseLearn which foods to choose►Learn cooking techniquesLearn cooking techniques►Strengthen self efficacyStrengthen self efficacy

►Learn critical viewing skills: Learn critical viewing skills: advertisingadvertising

entertainmententertainment

Persuasive AppealsPersuasive Appeals

ImmediateImmediate vs. remote outcome vs. remote outcome

HighHigh vs. Low likelihood vs. Low likelihood

Strong Strong vs. mild severity/payoffvs. mild severity/payoff

-- Health appeal: B-- Health appeal: Breast cancerreast cancer

-- Many other appeals: -- Many other appeals: Athletic Athletic performanceperformance

Attractive to peersAttractive to peers Self esteemSelf esteem

What works best to promote What works best to promote diet?diet?

FOR GIRLS: Immediate & Likely outcomesFOR GIRLS: Immediate & Likely outcomes

NotNot BC threat BC threat

FOR MOTHERS: Limited > frequent BCFOR MOTHERS: Limited > frequent BC

Positive > negative appeal Positive > negative appeal

Multiple > single appealMultiple > single appeal

Subtle > vivid styleSubtle > vivid style

Why use BC threat sparingly?Why use BC threat sparingly?

►Not appropriate in Not appropriate in mediamedia messages for messages for girlsgirls

►Lack of intuitive connectionLack of intuitive connection

Complex causal chainComplex causal chain

►Lengthy time lag to outcomeLengthy time lag to outcome

Food ----------------------Food ---------------------- Harm Harm

►Already perceive greater risk than actualAlready perceive greater risk than actual

Where’s diet on NCI list?Where’s diet on NCI list?

1.1. AgeAge2.2. Personal history of BCPersonal history of BC3.3. Family historyFamily history4.4. LCISLCIS5.5. Gene changes Gene changes (BRCA1 BRCA2)(BRCA1 BRCA2)

6.6. Age of menarcheAge of menarche7.7. Age of first child birthAge of first child birth8.8. HRT (E+P)HRT (E+P)

NCI List NCI List (continued)(continued)

9. White race9. White race

10. Radiation therapy10. Radiation therapy

11. Breast density11. Breast density

12. Took DES12. Took DES13. Overweight (13. Overweight (post-menopause)post-menopause)

14. Lack of physical activity 14. Lack of physical activity

15. Drinking alcohol 15. Drinking alcohol

Note at end of NCI list:Note at end of NCI list:

““Other Other possiblepossible risk factors are risk factors are under study….under study….eeffect of diet” ffect of diet”

Survey of adult women listing Survey of adult women listing perceived seriousness of BC risk perceived seriousness of BC risk

factorsfactors

ScoreScore 0-10 scale0-10 scale

9 Genetics / Family history9 Genetics / Family history

7 HRT7 HRT

6 High-fat foods in childhood6 High-fat foods in childhood

6 Obesity in childhood6 Obesity in childhood

4 Chemicals / Pesticides4 Chemicals / Pesticides

If message presents If message presents breast cancerbreast cancer appeal…appeal…

Most Credible BC Institutional Sources: Most Credible BC Institutional Sources: ► American Cancer SocietyAmerican Cancer Society► Federal agencies Federal agencies (CDC/NIH)(CDC/NIH)

► Medical centersMedical centers► Foundations Foundations (Komen)(Komen)

► Universities Universities (MSU)(MSU)

Best personalized Best personalized messengersmessengers to convey breast cancer to convey breast cancer

appeal…appeal…

1. Typical survivor 1. Typical survivor MomMom

2. Medical expert 2. Medical expert MomMom

3. Typical girl/mother 3. Typical girl/mother Mom, Girl Mom, Girl

4. Celebrity4. Celebrity Girl, MomGirl, Mom

5. Unique character? 5. Unique character? GirlGirl

Channels:Channels: GIRLSGIRLS PARENTSPARENTS

► TV PSA spotsTV PSA spots ► TV entertainment insertsTV entertainment inserts► Internet gamesInternet games► Posters / Comics / Play bookletsPosters / Comics / Play booklets

► Magazine/NP feature storiesMagazine/NP feature stories ► Internet websitesInternet websites► Printed instructional materials Printed instructional materials

Non-BC diet messages in Non-BC diet messages in mediamedia

HUGE AMOUNT OF “CHILDREN & DIET” HUGE AMOUNT OF “CHILDREN & DIET” CONTENT CAN BE LEVERAGED: CONTENT CAN BE LEVERAGED:

Number of stories in Number of stories in USA Today USA Today 2000-20052000-2005

►488 Diet total488 Diet total

-- 38 Diet & BC-- 38 Diet & BC

-- 331 Diet & Children-- 331 Diet & Children

-- 2 Diet & BC & Children-- 2 Diet & BC & Children

NEWS COVERAGE in National MediaNEWS COVERAGE in National Media

Environmental risk factors for breast cancer Environmental risk factors for breast cancer (N= 231 stories in 2003-04)(N= 231 stories in 2003-04)

► 3% BC & obesity 3% BC & obesity

► 2% BC & eating certain unhealthy foods2% BC & eating certain unhealthy foods►1% BC & eating certain beneficial foods 1% BC & eating certain beneficial foods ►1% Parents discourage obesity due to BC1% Parents discourage obesity due to BC

Advocacy ApproachesAdvocacy Approaches

GOAL:GOAL: Alter policies/practices of Alter policies/practices of

food-related organizations food-related organizations

TARGETS: TARGETS: Government agenciesGovernment agencies

Restaurant chainsRestaurant chains

TV networksTV networks

SchoolsSchools

Influencing OrganizationsInfluencing Organizations

►Direct lobbying/lobbyingDirect lobbying/lobbying (oral, written) (oral, written)

►Augmented by Augmented by perceived public perceived public opinionopinion

-- -- endorsementsendorsements from associations from associations -- sentiment in public-- sentiment in public forums forums -- comments in -- comments in radioradio call-in programs call-in programs -- published -- published commentarycommentary andand letters letters -- direct -- direct inputinput via mail via mail andand calls calls -- public opinion -- public opinion pollspolls

Influencing organizations:Influencing organizations: Role Role of of

mediamediaRaise diet/Raise diet/obesityobesity issue on news issue on news

agendaagenda

VOLUME & PROMINENCE OF STORIESVOLUME & PROMINENCE OF STORIES

Shape public opinion: editorial stanceShape public opinion: editorial stance

selection of newsselection of news