From online support to cancer control: Analyzing cervical cancer testimonies using narrative typology

Theoretical Background and research questions/hypothesis:

Cervical cancer is the fourth most prevalent cancer among women globally (WHO, 2022), prompting many women diagnosed with cervical cancer to seek online support to increase knowledge about the disease. The online network National Cancer Coalition (NCC) offers a webpage, titled “The Patient Journey,” that features patient and survivor testimonials extending support and guidance to women diagnosed with cervical cancer.

Narrative communication mirrors the way people receive information. Therefore, narrative is a recognizable and often digestible means of receiving information. One characteristic of narrative is that it carries a sequence, such as found in the organization of a testimony.

A typology of application of cancer control (Kreuter et al., 2007) helps investigate distinct capabilities of narratives to affect cancer control. Specifically, the typology proposes that the capabilities of narratives (which, when shortened are testimonies)–to overcome resistance, facilitate information processing, provide surrogate social connections, and address emotional and existential issues–contribute to cancer control.

NCC sorts testimonies into supportive frameworks, like empathy, and according to questions like, “What was most helpful to you when you were first diagnosed?”. This study investigates whether these testimonies align with a typology for cancer control with the research question: How do the testimonials on “The Patient Journey” reflect the typology of application of cancer control?

Methods:

Using the typology of application of cancer control, this study uses a thematic analysis methods to examine cervical cancer testimonials. Since the testimonies are a publicly available resource, IRB approval is not required. A total of 66 testimonies were obtained in April 2023. Four testimonies in Spanish were removed (n=62).

Results:

Preliminary results show support for three concepts of the typology. The first concept is overcoming resistance to cancer prevention behaviors, particularly those related to prevention. NCC testimonies demonstrate self-efficacy, which is key to overcoming resistance to cancer prevention behaviors like screening: “All I can say is having annual exams is the single most important thing a woman can do for yourself.”

The next concept supported by the testimonies is providing surrogate connections. Readers may develop parasocial support through testimonies by being introduced to characters in familiar situations: “[My doctor’s] voice began to shiver as she read to me my positive for cervical cancer results.”

Third, strongest support appears for addressing emotional and existential issues. This approach to testimony advocates for survivorship and living a good quality of life despite diagnosis: “Today, I’m celebrating my fifth year of being cancer free!!!! I’m advocating, educating and LIVING a life of GRATITUDE!!”

Conclusions:

Testimonies can offer support for individuals experiencing disease. Cervical cancer testimonies can exhibit strong storytelling capabilities and may be efficacious in furthering the efforts aimed at mitigating this preventable disease.

Implications for research and/or practice:

Implications support health communication, promotion, marketing and cancer support. Results may inform how networks present the testimonies of cancer patients and other stakeholders to better motivate positive health behaviors across the cancer control spectrum. Further, this study aids researchers in testing the utility of the typology for cancer control.