From the small screen to breast cancer screening: examining the effects of a television storyline on awareness of genetic risk factors

ABSTRACT

Background: The topic of breast cancer genetics entered the public discourse following Angelina Jolie's 2013 announcement that she carries the BRCA1 mutation and underwent a prophylactic double mastectomy to reduce her breast cancer risk. A year prior to Jolie's announcement, the teen drama 90210 ran an eight-episode story arc on the BRCA gene mutations. This study focuses on an evaluation of the impact of this particular media text within the broader context of research on the persuasive effects of entertainment narratives (i.e. entertainment education).

Method: The evaluation consisted of two complementary studies of adult women: a pre-test/post-test study using a panel sample of regular television viewers who were directed to watch a particular episode (Study 1), and a cross-sectional study using a convenience sample of frequent 90210 viewers (Study 2).

Results: In both studies, storyline exposure was associated with increased knowledge (familiarity with the BRCA gene, knowledge about mastectomy). Study 1 additionally saw evidence of increased fears regarding the consequences of the BRCA gene and intentions to talk to a doctor. In Study 2, the number of episodes viewed was positively related to both knowledge and behavior (finding out about one's family history of breast cancer).

Conclusions: These findings suggest that despite unprecedented changes in the ways audiences engage with and consume entertainment media, television narratives remain a powerful method of educating viewers about health risks and inspiring them to take action.

KEYWORDS:

• Breast cancer
• ovarian cancer
• BRCA
• health communication
• health behavior
• entertainment education
• television
• media messages

Ethical approval

Both studies underwent human subjects review and were granted exemption by the University of Southern California's Institutional Review Board.

Disclosure statement

No potential conflict of interest was reported by the authors.

Acknowledgement

The authors thank Michelle Xiao for her assistance with survey development, data analysis, and other aspects of this project, and Lauren Cafferty for help with manuscript preparation. This work was previously presented, in part, at the 2013 National Conference on Health Communication, Marketing, and Media.

Notes on contributors

Erica L. Rosenthal, Ph.D. is the Senior Research Associate for Hollywood, Health & Society, a program of the Norman Lear Center at the University of Southern California's Annenberg School for Communication and Journalism, where her work examines the content and impact of entertainment storylines addressing health and social issues. Her research interests center around the mechanisms underlying the influence of media messages on attitudes and behavior.

Sandra de Castro Buffington, M.P.H. is the Founder of StoryAction and former Director of the Global Media Center for Social Impact at the UCLA Fielding School of Public Health. At the time of this research, she was the Director of Hollywood, Health & Society. Her research measures the profound impact of entertainment media on knowledge and behavior.

Galen Cole, Ph.D., M.P.H., L.P.C., W.C.P. is a licensed counselor in private practice. At the time of this research, he was an Associate Director at the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. His interests include communication research across a number of different settings, including clinical practice, entertainment, and both social and broadcast media.

Additional information

Funding

This project was supported by two Cooperative Agreements granted by the Centers for Disease Control and Prevention (1-U38-HM-00020-5; 1-U38-CD-00139-1). Pursuant to these Cooperative Agreements, CDC funds were used to support formative and summative evaluation activities on the content and impact of TV storylines, but not research. The findings and conclusions of this report are those of the authors and do not necessarily represent the official position of CDC.