Keynote given at the Broadcast Education Association on April 17, 2016. Purpose was to portray ways in which the media can play to influence agenda setting in an era of new communication channels.

1. Cancer Prevention & Control in the Changing
Communication Landscape
Bradford W. Hesse, PhD
Chief, Health Communication and
Informatics Research Branch

2. In 2005, 61.6% (+/- 1.6) of Americans
thought of cancer as a death sentence.
Is it?

3. In 2015, news outlets reported that
cancer is “just bad luck.”
Is that
right?

4. What do the
Data Say? What researchers found:
Correlation between
• Type of cell & life time risk
• Cells that divided frequently had
greater probability of mutation
• Unless prevented …
“It’s like ... traffic patterns.There is a
tight correlation between the number
of cars on the roads and the number of
accidents, but that doesn’t mean that it’s
pure bad luck if you have an accident.
Bad luck is not scientific: Many cases can
be prevented”

5. Age-Adjusted Mortality

6. Unpacking Trends: Males
public health
control of h-pylori
public health
control of tobacco
early detection,
better treatment

7. Unpacking Trends: Females
public health
control of h-pylori
public health
control of tobacco
early detection,
better treatment

8. 224,210
preventable,

9. 371,040
detectable, treatable

10. 604,040
detectable, treatable

11. 836,710
detectable, treatable

13. Just a 1% reduction would save $400 billion

14. The Role of Public
Media

15. 0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
1900
1905
1910
1915
1920
1925
1930
1935
1940
1945
1950
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
Y ear
PerCapitaCigaretteConsumption
*Age-adjusted to 2000 US standard population. Source: Death
rates: US Mortality Public Use Tapes, 1960-2000, US Mortality Volumes, 1930-1959, National Center for Health Statistics,
Centers for Disease Control and Prevention, 2002. Cigarette consumption: US Department of Agriculture, 1900-2000.
10
20
30
40
50
60
70
80
90
Age-AdjustedLungCancerDeath
Rates*
100
0
Female lung cancer
death rate
Male lung cancer death
rate
Per capita cigarette consumption
Public Health
fights back
Advertising

16. Trend: Marketing to Women
Communication Response
Christy Turlington, Courtesy
CDC

17. Trend: Marketing to Children
Communication Response

18. Trend: Going Global
Communication Response

19. But do we need science?
Isn’t communication really
just common sense?*
*Any resemblance to persons living or dead is purely
coincidental

20. Philip Morris Anti
Smoking Campaign*
*Source: PhilipMorrisUSA.com
Anti-Smoking Campaigns: Philip Morris

21. Philip Morris Anti
Smoking Campaign*
*Source: PhilipMorrisUSA.com
Counter-normative
Communication
Anti-Smoking Campaigns: Philip Morris

22. Philip Morris Anti
Smoking Campaign*
*Source: PhilipMorrisUSA.com
Social
Modeling for Adult
Smoking
Anti-Smoking Campaigns: Philip Morris

23. Philip Morris Approach Increased Smoking

24. Philip Morris Approach Increased Smoking

25. Truth Campaign Reduces Smoking
Rates “1200 People”
•Appeal to
independence
•High “sensation
value” filming
•Data presented
as narrative

26. Deliberate Obfuscation
Source: http://legacy.library.ucsf.edu/tid/rgy93f00/pdf
Oxford Publishers, 2008

27. Deliberate Obfuscation

29. Inadvertent Obfuscation

30. Other Attempts at Obfuscation

31. Confusion Can Cost Lives

32. Confusion Can Cost Lives
“One in four people in
the United States—nearly
80 million—are infected
with at least one type of
human papillomavirus
(HPV)”

33. The New Media
Environment

34. Rise in channels, voices, & conflicting
messages

35. Rise in channels, voices, & conflicting
messages

36. Rise in channels, voices, & conflicting
messages

37. Rise in channels, voices, & conflicting
messages

38. Everything causes?
Can prevent?
Know how?
+7.7%
Confusion
hints.cancer.gov

39. Everything causes?
Can prevent?
Know how?
+7.7%
-1%
Confusion
hints.cancer.gov

40. Everything causes?
Can prevent?
Know how?
Confusion
+7.7%
-1%
+3.7%
hints.cancer.gov

41. Entering an Era of
“Data Smog”
Decision Paralysis
Anxiety
Confusion
Impulsivity
Frustration,Anger

42. Katherine
Smith
Jeff
Niederdeppe
Kelly
Blake
Joseph
Cappella
Research in the New
Media Environment

43. 1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
Fundamental Shifts

44. Fundamental Shifts
1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
Tuesday
July 9, 2002
Online First
article published
Wednesday
July 10, 2002
Thursday
July 11, 2002
Friday
July 12, 2002
Saturday
July 13, 2002
Doctors Receive
Journal Issue
Issue Published
Radio,TV news
*See: Hesse BW. The Patient, the Physician, and Dr. Google. JAMA Virtual Mentor. 2012;14(5):398-402.
NHLBI detects rise in
breast cancer for
PremPro
Patients access article online

45. 1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
Fundamental Shifts

46. Fundamental Shifts
1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
NEW
OPPORTUNITIES
•Rapid response
•Digital press kits
•Quick tracking
•Podcasts
•Sharable widgets

47. Fundamental Shifts
1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
NEW
OPPORTUNITIES
•Better integration of online
and print content
•Multimedia content for public
and the press
•Data repositories for “open
science”
•Digital Object Identifiers for
journalistic content
jama.jamanetwork.com

48. Fundamental Shifts
1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
NEW
OPPORTUNITIES
•Rapid surveillance of
digital life: “Infodemiology”
•Development of
algorithms to search
archived broadcasts
•Just in time, adaptive
interventions

49. Fundamental Shifts
1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation Accelerating Analysis of
Cancer Trends through
Web-scraping
NEW
OPPORTUNITIES

50. Fundamental Shifts
1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
Media are narrowing
to serve interest-based
market segments

51. Fundamental Shifts
1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
Disparities Frame
Framing to fit
perspective
Matthew Kreuter,Wash U
NEW
OPPORTUNITIES

52. Fundamental Shifts
1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
Impact Frame
Framing to fit
perspective
Matthew Kreuter,Wash U
NEW
OPPORTUNITIES

53. Fundamental Shifts
1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
Progress Frame
Framing to fit
perspective
Matthew Kreuter,Wash U
NEW
OPPORTUNITIES

54. Fundamental Shifts
1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
3.25
3.5
3.75
4
4.25
4.5
4.75
5
Progress Impact Disparity
Low Mis
High Mis
3.75
4
4.25
4.5
4.75
5
Low Mistrust
High Mistrust
I want to be screened for colon
cancer? Framing X Medical Mistrust
Results
Framing to fit
perspective
Matthew Kreuter,Wash U
NEW
OPPORTUNITIES

55. Fundamental Shifts
1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
NEW
OPPORTUNITIES
Targeting stories
to perspectives
Perspective
Framed Story Sample Article
NCI Data
Platform for
localization

56. Fundamental Shifts
1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
TheTrustedVoice Pundits
Newscasters

57. Fundamental Shifts
1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
Time Magazine, 2006

58. Fundamental Shifts
1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
NEW
OPPORTUNITIES
Matthew
Kreuter

59. Fundamental Shifts
1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
NEW
OPPORTUNITIES
When is genomic information communicated most accurately?
Prestige
Familiarity
Co-construction

60. Fundamental Shifts
1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
NEW
OPPORTUNITIES
When is genomic information communicated most accurately?
Prestige
Familiarity
Co-construction
Prestige
Familiarity
Co-construction
Journalist + Source

61. Fundamental Shifts
1. Speed / Dynamism
2. Diversity of perspectives / “narrowcasting”
3. Broadened participation
NEW
OPPORTUNITIES
BLS USDA CDC
Community Health Data

62. Communicating
Evidence to the Public

63. Making Data Talk
Inform Support
Decisions
Educate Persuade
Nelson, Hesse, Croyle, 2009

64. Knowledge in the Head*
Knowledge in The World*
Task Relevant
Schemata
General model

65. Chapter 4:Visual Displays

66. SOURCE: http://alleydog.com/topics/sensation_and_perception.php
Perceptual Basics

67. source: Carpenter PA, Shah P. A model of the perceptual and conceptual processes in graph comprehension.
J Educ Psychol. 1999, 91(4): 690-702.
• Constructive process
• Gaze goes to center
for pattern
• Contiguous labels for
meaning
• Left to right tendency
in western culture
• Perceptual rules
guide meaning
Cognitive / Perceptual
Research

68. source: Carpenter PA, Shah P. A model of the perceptual and conceptual processes in graph comprehension.
J Educ Psychol. 1999, 91(4): 690-702.
• Constructive process
• Gaze goes to center
for pattern
• Contiguous labels for
meaning
• Left to right tendency
in western culture
• Perceptual rules
guide meaning
Visualizing Long Term
Change

69. • Constructive process
• Gaze goes to center
for pattern
• Contiguous labels for
meaning
• Left to right tendency
in western culture
• Perceptual rules
guide meaning
Hans Rosling, BBC
Visualizing Change
Dynamically

70. Overcome “small numbers” bias
& emotional response

71. Exceptional Case
Fallacy of small numbers;
Tversky & Kahneman, 1971
Illnesses
322,000,000
Hospitalizations
21,000,000
Prevented
Deaths
732,000

73. See: Fagerlin,A., Ubel, P.A., Smith, D. M., & Zikmund-Fisher, B. J. (2007). Making numbers matter: present and future research in risk
communication.Am J Health Behav, 31 Suppl 1, S47-56.
Icon arrays designed to convey
natural frequencies

74. Portraying trends to policy makers
Choropleth Maps: CDC Obesity Trends, BRFSS 1985

75. Nonsegmented geographic data
Isopleth “Weather Maps,” HINTS

76. Juxtaposing geographic distributions
Mortality Maps (SEER):
Lung Cancer Mortality
For Example:
Knowledge Maps (HINTS):
Does Smoking Cause Cancer?

77. Added User Controls
14 datasets spanning 6 years
NSF, NIH
Collaboration
Dissolving Barriers Between
Clinical and Community Health
source: Hesse, Bradford W. (2007). Public Health Informatics. In M. C. Gibbons (Ed.), eHealth Solutions for
Healthcare Disparities (pp. 109-129). NewYork, NY: Springer.

78. Take Away Points

79. Communicating Publicly about Cancer
is as Important Now as Ever

80. But the Science of Cancer is Becoming
Increasingly more Complex & Precise

81. The Public’s Reaction to Cancer Will
Be Driven by Emotion
“Communication can never
reshape everyone’s deep
passions about what feels
safe. Risk management …
must account for the
mistakes we sometimes
make.”
-David Ropeik
http://undark.org/article/know-this-first-risk-perception-is-always-irrational/

82. But Patients Are Driven to Investigate,
Understand, and Act

83. Dose > Response
Old Public Health Models Are
Insufficient

84. “Meaningful Use”
Safety, Quality
Improvement
Patient
Engagement
Continuity of
Care
Population
Health
Privacy,
Security TRUST
New Models,Taking Advantage of New
Information Environment,Are Needed

85. Together,We Can Stand
Up to Cancer
Thank You!

86. Together,We Can Stand
Up to Cancer
Thank You!