Telling stories for cervical cancer prevention: The impact of narrative features and processes on young women's HPV vaccination intentions.

摘要

Narrative persuasion research has identified two promising features that could influence behavior: (a) whether the character lives or dies (narrative outcomes) and (b) whether the character overcomes key barriers (narrative barriers). The current study manipulated both narrative features in a human papillomavirus (HPV) vaccine intervention---delivered via an online panel study---targeted to young adult women aged 18 to 26 (N = 246). Participants were randomly assigned to a 2 (survival vs. death) x 2 (social vs. structural barriers) between subjects experiment. Compared to death narratives, survival narratives increased narrative plausibility, consistency, and coverage, and yielded greater HPV vaccination self-efficacy and lower perceived barriers to action. Narrative features interacted, such that survival narratives featuring social barriers led to greater transportation into the story than other combinations. Moderated mediation analysis was employed to test 10 theoretically-derived mediators, including transportation, four factors of believability, perceived barriers, perceived benefits, risk susceptibility, risk severity, and self-efficacy. Two variables emerged as mediators of the narrative message--behavioral intention relationship: transportation and risk susceptibility. The results provide an important first step toward building a more comprehensive and integrated model of narrative persuasion processing. These findings also have practical applications for guiding narrative public health message design in cervical cancer prevention campaigns. Results also highlight the clinically significant impact that narrative-based interventions can serve toward lessening the incidence of cervical cancer through an increase in HPV vaccination for young women. Directions for future work in the development of narrative persuasion and cancer communication are discussed.