Longitudinal effects of narrative versus non-narrative health messages on promoting women's cervical cancer-related knowledge, attitudes and behavior

Background: The power and perseverance of stories has been recognized for thousands of years, yet Western medicine often disregards the use of narrative. This research empirically tested whether a fictional narrative produces a larger and longer-lasting impact on health-related knowledge, attitudes, and behavior than the identical information presented in a more traditional, nonfiction, non-narrative format. Method: A random sample of European-American, Mexican-American, and African-American women between the ages of 25-45 living in the Los Angeles area was surveyed at three time points: (1) a pretest before viewing either a narrative or non-narrative cervical cancer-related film; (2) a post-test two weeks after viewing (N = 758); and (3) a six month follow-up survey (N = 704). Results: At two weeks post-viewing, both films produced a significant increase from pretest in cervical cancer-related knowledge and attitudes, but these effects were significantly higher for the narrative film. At six months, viewers of both films retained greater than baseline knowledge and more positive attitudes toward Pap tests. Importantly, at six months women who saw the narrative had more positive change in behavioral intent to be screened and were significantly more likely to have made an appointment for a Pap test than those who saw the non-narrative. Conclusion: These findings underscore the potential of narrative to serve as a valuable and underutilized tool to promote health domestically and abroad and reduce health disparities. Moreover, although this particular research focused on cervical cancer, the results have clear implications for virtually all health communication.