Developing persuasive messages to advance health equity in cancer treatment

Racism has a significant impact on health outcomes and racial health disparities, but little has been published on how to communicate effectively about racism, particularly in and around oncology. This project sought to gain insight from populations who experience structural racism in cancer treatment and to test draft messages about health equity in cancer treatment with audiences who have limited understanding of structural racism and its connection to cancer.

We conducted three phases of research: 12 virtual focus groups and 11 virtual in-depth interviews with cancer patients/caretakers; a nationwide online survey (n = 2500) with the general population (n = 2000) and an oversample (n = 500) of people of color; and seven virtual focus groups with individuals of varied races/ethnicities and cancer patients/caretakers.

Prior to message exposure, some struggled to connect cancer treatment disparities to systemic racism or to assess combating inequity as actionable. Message content about structural racism in cancer treatment at times generated polarized reactions. A narrative style video testimonial portraying first-hand narratives of racism in cancer treatment, however, generated receptive responses across all audience subgroups.

Exposure to statements about racism in cancer treatment can strengthen the perception that race is related to receiving prompt, quality cancer treatment and to the importance of addressing equity. The 'what' and 'how' of communicating that information are important; well-intentioned messages on racism in cancer treatment can be alienating and have unintended consequences (e.g. counterarguing) if not brief, inclusive, direct, and framed for 'the all.'