Stories and social norms: The impact of narrative and non-narrative films on perceptions of social norms regarding cervical cancer prevention and detection

Background: Although pap tests can detect and prevent cervical cancer, many women are not regularly tested. Descriptive social norms – the perception of how common it is for others to engage in a particular behavior – have been found to be an important predictor of cervical cancer screening and prevention behaviors. Objective: To compare the effectiveness of a narrative (story-based) and a non-narrative (fact-based featuring doctors and patients) film, each containing the same facts regarding cervical cancer, on women's perceptions of social norms regarding Pap testing and use of the HPV vaccine. Methods: Over 1,000 women aged 25-45 of Hispanic, African-American, Korean and European descent were administered a pre-test telephone survey and then mailed a film of the narrative or non-narrative educational materials (randomly assigned). Women were re-contacted one to two weeks and then six months later to participate in a post-test and follow-up survey. Results: The narrative film was more effective than the non-narrative film at changing women's social norms. Specifically, women who viewed the narrative film were more likely to perceive that other women had received abnormal Pap results or had the HPV vaccine than those who viewed the non-narrative film. Discussion: Narrative-based educational materials appear to have a greater impact on women's descriptive social norms regarding Pap testing and perceptions of the HPV vaccine than do non-narrative materials. Because of this, campaigns and interventions concerning women's health should consider using narrative-based materials.