Developing Breast Health Messages for Women in Rural Populations

In an effort at developing messages that are sensitive to societal determinants and expectations about probreast health behaviors for an underserved population, a qualitative approach was driven by the research question, "What message strategies will motivate Appalachian women to attend to breast health issues and become actively involved in their own breast health?" Based on group interviews with 77 women, two types of messages were found to be particularly motivating: messages that reflect the women's roles as care givers and the self-perceived reality that the women in this population cannot depend on anyone but themselves. ********** As a health communicator, there are many possible things to say about breast cancer, but it can be hard to know what specifically to say that will get attention of a particular population and motivate positive participation in breast heath activities. Being a high-profile disease brings important awareness, but people may be so aware of breast cancer that they feel adequately knowledgeable about it and stop paying attention to important information. Making matters more complicated, breast health information may be interpreted differently based on gender, economic class, geography or other cultural factors. Certain populations such as rural women may not have the same access to breast health information as others. Also, research has suggested that societal factors may oppress women in rural, at-risk populations and compromise self-efficacy, as their health may be perceived to be a function of their environments and not of volitional, prohealth behaviors. Given this complicated communications environment, research into breast health message strategy seems warranted. In the advertising literature, message strategy refers to "what to say," whereas "creative tactic and execution" refer to "how it is said." More generally, message strategy is defined as a guiding approach to an institution's promotional communication efforts for its products, services or itself (Taylor 1999). Although this definition speaks of products or services, message strategy is also a relevant concern for health promotion. It has long been asserted in advertising that different messages are needed for different buying situations (Kotler 1965; Taylor 1999; Vaughn 1980). Some buying decisions (behaviors) are more motivated by "rational" concerns such as price and efficiency. Others may be more motivated by "emotional" concerns such as self-esteem and fear. Still others may be a combination of the two. Each of these situations calls for a different message strategy to attract the intended receiver's attention and ultimately motivate that receiver to perform the action desired by the communicator. The same concept is true for health promotion messages such as those regarding breast health behaviors. Depending on the population, breast health behaviors may be motivated by rational and/or emotional concerns and these motivations must be addressed through the health messages. Regardless of how they are communicated (via PSA/advertising, brochures, video, Web sites or person-to-person), breast health promotional messages must break through the clutter of all messages in the market. Then, the messages must motivate the receiver to engage in the advocated behavior (self-examinations, diet, weight control, doctor visits, etc.). This article uses the concept of message strategy from the advertising literature to inform message design on breast health aimed at a specific underserved and at-risk population, rural Appalachian women. The research attempts to identify "what to say" in public health campaign message strategy to empower these women to be active in their own breast health. THEORETICAL PERSPECTIVES IN HEALTH COMMUNICATION Although this study adopts an inductive approach, several theories of health communication commonly used to inform message design in prohealth campaigns may offer potential frameworks for exploring the results and complement the advertising literature on message strategy. …