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The Ability of Narrative Communication to Address Health-Related Social Norms

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The Ability of Narrative Communication to Address Health-Related Social Norms %0*JSTS IRSR INTERNATIONAL REVIEW of SOCIAL RESEARCH Volume 3, Issue 2, June 2013, 131-149 International Review of Social Research The Ability of Narrative Communication to Address Health-related Social Norms Meghan Bridgid MORAN• San Diego State University Sheila T. MURPHY University of Southern California Lauren B. FRANK Portland State University Lourdes BAEZCONDE-GARBANATI University of Southern California Abstract: Social norms are an important predictor of health behavior and have been targeted by a variety of health communication campaigns. However, these campaigns often encounter challenges related to the socially specifc context in which norms exist: specifcally, the extent to which the target population identifes with the specifc reference group depicted and the extent to which the target population believes the campaign’s message. We argue that because of its capacity to effect identifcation among viewers, narrative communication is particularly appropriate for impacting social norms and, consequently, behavioral intention. This manuscript presents the results of a randomized trial testing the effectiveness of two flms – one narrative, one non-narrative – in changing perceived social norms and behavioral intention regarding Pap testing to detect cervical cancer. Results of the study indicate that the narrative flm was in fact more effective at producing positive changes in perceived norms and intention. Keywords: narrative communication, identifcation, perceived social norm, behavioral intention, cervical cancer. Introduction would approve of, play an important role in health behavior. A wide body Perceived social norms, or what an of research has found evidence linking individual believes others are doing or perceived norms to a variety of health •e-mail: [email protected]. Meghan Bridgid Moran, Ph.D is Assistant Professor at School of Communication, San Diego State University. Sheila T. Murphy is Associate Professor at Annenberg School for Communication & Journalism, University of Southern California. Lauren B. Frank, Ph.D., MPH is Assistant Professor at Portland State University, Department of Communication, University Center Building. Lourdes Baezconde-Garbanati, Ph.D., MPH is Associate Professor in Preventive Medicine and Sociology at Keck School of Medicine, University of Southern California. This work was supported by the National Cancer Institute (NCI) for TRO1 - Transforming Cancer Knowledge, Attitudes and Behaviors Through Narrative (awarded to the University of Southern California (USC) R01CA144052-Murphy/Baezconde-Garbanati). We wish to acknowledge Doe Mayer & Jeremy Kagan at the USC School of Cinematic Arts, the Change Making Media Lab at USC and Paula Amezola de Herrera at the USC Keck School of Medicine for their contributions to this project. The content is solely the responsibility of the authors and does not represent offcial views of the NCI or of the National Institutes of Health. © University of Bucharest, June 2013 Unauthenticated Download Date | 5/5/16 1:08 AM 132 | IRSR Volume 3, Issue 2, June 2013 behaviors, such as alcohol use (Keyes, arguing that narrative communication, Schulenberg, O’Malley, Johnston, because of its ability to increase Bachman, Guohua & Hasin, 2012), viewer identifcation with characters, condom use (Albarracin, Kumkale & is uniquely positioned to impact social Johnson, 2004) andcancer screening norms. We testthis assumptionby (Smith-McLallen & Fishbein, 2008). analyzing the results of an experimental As a result, many health communication study comparing two 11-minute health campaigns seek to impact behavior by communication flms – a narrative changing social norms. But despite the and a non-narrative – that contain role perceived norms play in predicting the identical information regarding behavior, the evidence for the success the cause, prevention and treatment of norm-based campaigns is mixed of cervical cancer. Prior to doing (Campo et al., 2003). We argue that so, however, we frst briefy review many of these campaigns fail because the relevant literature on perceived they do not address the ‘social’ aspect social norms, interventions that of social norms. That is, in order to be seek to change behavior by targeting successful, a social norms campaign social norms, and the characteristics must locate the targeted normative of narrative communication that belief within a specifc social context. make it appropriate for social norms To do this, the campaign must identify campaigns. the appropriate reference group and address the targeted norm in a way that will resonate within the target Perceived Social Norms population. Narrative communication (defned Perceived social norms are defned as as ‘a representation of connected frames of reference through which the events and characters that has an world is understood (Sherif, 1936). In identifable structure, is bounded in practice, the construct of social norms space and time, and contains implicit is divided into two sub-constructs: or explicit messages about the topic descriptive norms and subjective being addressed’: Kreuter, Holmes, (or injunctive) norms. Descriptive Alcaraz, Kalesan, Rath, Richert,… norms are typically defned as ‘what Clark, 2007: 222) is uniquely capable is commonly done,’ while subjective of impacting perceived norms in a norms are defned as ‘what is contextually appropriate way. Although commonly approved and disapproved an expanding body of research [of]’ (Kallgren, Reno &Cialdini, 2000: identifes narrative communication 2002). as an innovative way to impact Perceived social norms have been knowledge, attitudes and behavior linked to myriad health behaviors (Kreuter, Green, Cappella, Slater, Wise, including condom use (Albarracin, Storey,…Woolley, 2007), research that Kumkale and Johnson, 2004), HIV-risk examines the infuence of narrative behaviors (Latkin, Forman, Knowlton communication on targeted social and Sherman, 2003) substance use norms is virtually nonexistent. The (Etcheverry & Agnew, 2008) and current manuscript addresses this gap, drunk driving (DeJong and Hingson, Unauthenticated Download Date | 5/5/16 1:08 AM Meghan Bridgid Moran et al. The Ability of Narrative Communication | 133 1998). Most relevant for present that the perceived norm of a group purposes is evidence that social norms subsequently infuences behavior. play an important role in predicting Recently, the integrative model of cancer-screening behavior. McLallen behavioral prediction (IMBP; Fishbein, and Fishbein (2008) found that both 2000) – an extension of the theory of subjective and descriptive norms reasoned action (Ajzen & Fishbein, contributed signifcantly to intentions 1980; Fishbein &Ajzen, 1975) and to get a mammogram (to screen for theory of planned behavior (Ajzen, breast cancer), colonoscopy (to screen 1985, 1991; Ajzen & Madden, 1986) for colorectal cancer) and PSA test (to – hypothesized that perceived norms screen for prostate cancer). impact behavior in conjunction with Several theoretical approaches have several other factors (attitudes, self- traditionally been used to conceptualize effcacy, environmental constraints the mechanisms through which social and skills and abilities). norms affect behavior. The social norms It must be noted that each of these approach (Berkowitz, 2004a; Perkins, frameworks focuses on perceived 2003; Perkins & Berkowitz, 1986) social norms, not actual social norms. provides theoretical reasoning for why There are several key implications perceived norms should play such a stemming from this conceptualization. role, arguing thatbecause individuals First, perceived social norms are are motivated to act in ways similar always specifc to a particular social to relevant others (e.g. a reference context (Sherif, 1936; Terry & Hogg, group) their perception of a reference 1996). That is, what is normative for group’s behavior will infuence his or one context (e.g. a library) may not be her subsequent behavior (Berkowitz, normative for another context (e.g. a 2004b). Social identity theory (Tajfel, party). Thus social norms are formed 1978; Tajfel & Turner, 1979) offers by referring to relevant others in order an additional way to conceptualize to infer appropriate conduct. These the mechanism through which norms groups of relevant others, known shape behavior. According to social as reference groups (Rimal & Real, identity theory, individuals have 2005) may be small (e.g. a group of numerous identities based on their close friends) to very large (e.g. an self-categorization as members of entire community). Moreover, this various groups. The social categories focus on perceivedas opposed to actual to which one belongs are cognitively social norms implies a relationship represented as prototypes. A prototype between what is actually occurring is one’s perception of a group’s defning in a social context, and what an behaviors, values, attitudes and beliefs individual perceives to be normative. – in other words, the perception of a An individual’s perceived norm may group’s norms. According to social or may not align with the actual norm identity theory, when individuals begin (that being the actual prevalence of a behavior or extent to which others to identify as group members, they approve of a behavior: Lapinski & begin to think of themselves in terms of Rimal, 2005). Although perceived the group’s prototype. It is through this norms often bear some relationship process, known as depersonalization, to actual social norms, perceived Unauthenticated Download Date | 5/5/16 1:08
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